Microsoft Word - Food_Safety_Cert_Insturct

Chk:_____ MO:_____ DR:____/____/____ CN:_____________________________

InstructionsandApplicationFormfora

PhiladelphiaFoodSafetyCertificateProcessingProcedure

1. Stationaryfoodbusinessesmusthaveanemployeecertifiedinfoodsafetypresentatalltimes.

2. Thesedesignatedemployeesmustcompleteafoodsafetycoursethatisapprovedbythe

PhiladelphiaDepartmentofPublicHealthandmustobtainanofficialCityofPhiladelphiaFood

SafetyCertificate(Certificate).

3. TheCer

tificatemustbepostedatthefoodbusinesswherecustomerscanviewit.

4. Certificatesarevalidforfiveyears,afterwhichtheemployeemustcompleteandpassanother

foodsafetycourseapprovedbythePhiladelphiaDepartmentofPublicHealth.

5. AnapplicantcanapplyinpersonorbymailtotheDepartmentofPublicHealth,OfficeofFood

Protection,321UniversityAvenue,Philadelphia,PA19104.

6. ToapplyforaCertificateoraReplacementCertificate,applicantcanapplybymail orinperson

attheOfficeofFoodProtection.Toapplytheymustsubmit:

a. Acopyofthecoursecertifi

cate,and

b. AcompletedapplicationforaCityofPhiladelphiaFoodSafetyCertificationForm(available

online),and

c. Acertifiedcheckormoneyorderfor$30madeouttotheCityofPhiladelphia–EHS.Money

ordersorcashier’scheckscannotbeolderthan30days.

d. Forareplacementcertificate,acertifiedcheckormoneyorderfor$50madeouttotheCity

ofPhiladelphia–EHSalongwithastatementofthereasonwhyareplacementcertificateis

neededmustbesubmittedwiththeapplication.Moneyordersorcashier’scheckscannotbe

olderthan30days.

7. Applicantscannoteontheapplicationthattheywouldliketobenotifiedwhenthecertificateis

readyforpickupiftheyprefer.

8. Withinamaximumof30businessdaysafterreceiptofacompleteapplication,theOFPwillmail

thePhiladelphiaFoodSafetyCertificatetothemaili

ngaddressprovidedontheapplication

submittedbytheapplicantornotifytheapplicanttheirCertificateisavailableforpickup.

9. Allgroupsubmissionsofapplicationsbyasinglecorporation,ifagreedtobythecorporate

representative,maybemailedbacktothecorporateaddressinasinglemailingfordistribu

tion

bythecorporationtotheapplicants.

10. Businessessellingonlypre‐packaged,non‐hazardousfoodsareexemptfromthisrequirement.

OfficeofFoodProtection

321UniversityAve,2

Floor

Philadelphia,PA19104

215‐685‐7495

www.phila.gov/health/foodprotection

Chk:_____ MO:_____ DR:____/____/____ CN:_____________________________

CITYOFPHILADELPHIA

DEPARTMENTOFPUBLICHEALTH

ApplicationforFoodEstablishmentPersonnel

FoodSafetyCertificate,orCertificateReplacement

PRINTCLEARLYUSINGCAPITALLETTERS.SEEATTACHEDINSTRUCTIONS.

CheckTypeofApplication:



Initial Replacement PaymentEnclosed$_________________

FirstName MiddleInitial

LastName

Home/MailingAddr

ess

Floor/Location/Apartment#

City

State ZipCode

DateofBirth

DayTelephone EveningTelephone

EmailA

ddress

EstablishmentNam

e

EstablishmentAddress

Pleasemailmethecertificate. Pleasenotifymewhenthecertificateisreadyforpick‐up. 

Pleasesendallfoodsafetycertificatestoasinglecorporateaddress.

FOROFFICEUSEONLY