application for food hygiene license (catering industry): (official seal) Date of application: Xx, XX, Department of Health, applied for the single address of the person in charge of the economic unit and the legal representative. Number of workers should be examined. Fixed assets (11,111 yuan) Use area (m2) Acceptance certificate for completion Original health permit number Application for permit items: attached materials (please tick "√" in the □ before the information provided) □ 1. Application form for health permit (provided by the health supervision agency in the sample area); □2. Original and duplicate of the original license and a copy of the industrial and commercial business license (a copy of the approval letter for appointment of the name of the industrial and commercial department); -3, production and business premises, site layout and production process flow chart; □4. Basic sanitation facilities (truthfully selected in the corresponding column of the health permit application); □5. Health management system (provided by employees and management personnel of 11 or more) and system (provided by health supervision institutions); □6. Obtain certification materials such as health inspection reports for the procurement of major food raw materials □7. List of health check-ups and health knowledge training for food employees (provided by the health supervision unit according to the health check-ups and training of employees); □8. Training certificate of the person in charge of the enterprise and the full-time (part-time) food hygiene administrator (issued by the supervision institution according to the training situation); □9. Qualification certificate of legal representative, owner or person in charge of production and operation (resolution of the board of directors, articles of association, appointment document or copy of ID card); □11, certificate of house ownership or lease, certificate of collective land use unit; □11, food hygiene supervision quantitative grading scale (issued by the district health supervision agency); □12. Health review opinions of health supervision institutions (issued by district health supervision institutions); -13, tableware, drinking utensils, food tools monitoring report, dining place air quality, microclimate monitoring report (provided by qualified inspection agencies identified by health administrative departments at or above the provincial level); □14. Other information required to be declared by the health administrative department. Sanitary facilities: 1. Disinfection facilities (disinfection vehicle, disinfection cabinet, steamer, disinfectant, ultraviolet disinfection lamp) 2. Dressing facilities (locker room, <; Equipped with ultraviolet disinfection lamp > More wardrobe) 3, toilet facilities (tap, sink, sink, disinfection pool, etc.) 4, lighting facilities (glass and other natural light ports) 5, lighting facilities (the kitchen should be equipped with double-layer waterproof lighting; Other lighting facilities) 6. Ventilation facilities (natural vents and mechanical ventilation and ventilation equipment) 7. Anti-corrosion facilities (refrigerators, freezers, cold storage, etc.) 8. Dust-proof facilities (doors, windows and roofs are sealed intact) 9. Fly-proof facilities (screen doors and screens) 11. Rat-proof facilities (no less than 61cm rat traps at the entrance of the warehouse, 2-3 poisonous baits are built in the yard. Laying a rat net with a diameter of not more than 1.6cm in sewers and ditches) 11, sewage discharge facilities (with sewers and unobstructed) 12, facilities for storing garbage and wastes (dustbins with flip covers, trash cans, etc.) Other issues to be explained: the contractor has informed the applicant of the materials required to apply for a sanitation permit at one time according to the requirements of laws and regulations, and our unit will provide the required information truthfully as required, and the contents are true and legal, in line with relevant national norms, standards and standards. If there is any falsehood, our unit is willing to bear the corresponding legal responsibility and bear all the consequences caused by it. Legal representative or person-in-charge (signature) of the applicant (seal) Year Month Year Month Year Month Day Department's opinion: (official seal) Year Month Day Health supervision agency's opinion: person-in-charge (signature): Opinions of the administrative department of public health: person in charge (signature): approval of licensing items: (official seal) Date and number of issuance: Date of issuance: Date of issuance:No.: Lu Wei Food Certificate () No. No. Validity Period: Year Month Day to Year Month Day Description 1. This application form shall be filled in by the applicant and submitted to the designated health supervision institution. 2. The words in this application form shall be concise and clear, and shall not be altered, and the blank shall be filled with the word "None". 3. Fill in the application scope and types of production and business operation for the "project applying for license". 4. Please tick "√" in the □ before the information provided. 5. Each document is arranged in the order in the data column attached to the application form and bound into a book. 6. This application form is made in duplicate, all printed or copied on A4 paper, and the font is D D D D D D D D.