Team of chefs doing paperwork at a restaurant

Notice of Intent to Operate a Food Premises Online Form

Are you a new owner of an existing fixed food premise?

Business Information

Business Name

Legal Name (if different from above)

Proposed date of opening

Category of Food Business (select one)

Primary Type of Food Business (select one)

Other (please specify)

Proposed Site Address

Site Name* (if applicable)

*Provide name of the community kitchen or commercial kitchen (e.g., church kitchen) if you are planning production there.

Fax Number

Phone Number

City/Town

Postal Code

Tobacco / Vape Sales

Website

Proposed Number of Seats (if applicable)

Proposed Number of Employees

Year-round or Seasonal

If seasonal, months of operation

Water Supply

Sewage Supply

Pest Control Contracted

Liquor License

Mailing Address (if different than site address above)

Mailing Address

City/Town

Postal Code

Fax Number

Owner Information

Owner Name

Phone Number

Owner Email Address

Confirm Owner Email Address

Primary Contact Information (if different from owner)

Primary Contact Name

Primary Contact Phone

Primary Contact Email Address

Confirm Primary Contact Email Address

Corporate Information (if applicable)

Corporation Name / Number

Corporation Phone Number

Corporation Address

Corporation City

Corporation Postal Code

Name of Principal Officer

Please acknowledge the following:

I understand that unless specifically advised to the contrary, I will be required to ensure that there is at least one food handler or supervisor on the premise who has an up-to-date Food Handler Certificate during every hour in which the premise is operating.

O. Reg 493/17: FOOD PREMISES

I understand all equipment, including cooking equipment, temperature-controlled compartments and sanitation facilities will need to be fully functional at the time of the pre-opening inspection in order to receive approval to open.

I understand that I will be required to submit floor plans / drawings electronically for review by public health prior to opening and ideally prior to construction activities commencing.

Upload Floor Plan

One file only.
2 MB limit.
Allowed types: jpg png pdf doc docx.

Upload Food Handler Certificate

One file only.
2 MB limit.
Allowed types: jpg png pdf doc docx.

The information on this form is collected under the authority of the Health Protection and Promotion Act in accordance with the Municipal Freedom of Information and Protection of Privacy Act and the Personal Health Information Protection Act. This information will be used for the delivery of public health programs and services; the administration of the agency; and the maintenance of healthcare databases, registries and related research, in compliance with legal and regulatory requirements. Any questions about the collection of this information should be addressed to Client and Community Support at 1-800-265-7293 ext. 7006 or clientcommunitysupport@wdgpublichealth.ca.

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Notice of Intent to Operate a Food Premises Online Form

Business Information

Mailing Address (if different than site address above)

Owner Information

Primary Contact Information (if different from owner)

Corporate Information (if applicable)

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