cez6F.015 Revision 02, 20 Apri 2019 PHILIPPINE ECONOMIC ZONE AUTHORITY FE CAVITE ECONOMIC ZONE Rosario, Cavite ENVIRONMENT HEALTH AND SAFETY DIVISION ARoLCATION FOR SANITARY PERMIT OF FOOD SERVICE AREA | TYPE OF APPLICATION: a LO new GU RENewaL, SANTARY PERMIT NUMBER = [ BUSINESS NAME: (Registered Name with DTI or SEC) ‘OWNERIS; Fi a CONTACT NUMBERIS: | | AUTHORIZED REPRESENTATIVE ~~ CONTACT NUMBERS; LOCATION OF FOOD ESTABLISHMENT: (Company Name & Adaress of CEZ Locator Enterprise) FOOD ESTABLISHMENT FACILITIES: (Pease checkal ‘appropriate boxes) a | O F000 PREPARATION AREAKITCHEN O omic area _ REQUIREMENTS: 7 aie as G1 PEzA Sentary inspection Repon (Showing onplance we ‘mandated by Chapter Il of PD 886: Code of Sanitation ofthe Philippines Het Coen ot ot Ha (nt ne nce eta Oey | © Kitchen waste Management Plan ‘or Sold Waste Management Plan of company that includes kitchen waste D1 Proot of Payment {for Sanitary Permit for Food Service Area Q Vaid Permit to Locate or ‘Proof of Application Don Business Name Contifcate Q Contract Agreement between the Locator Enterprises and Cantes DATE OF SANTARY NSPECNING EVALUATED By: NOTED By: Name & Signature of EHSD Staff "DC, Environment, Health & Safely Division