Verification of Mobile Food Facility Commissary is the Sacramento County Environmental Management Department (EMD) form on which the owner of a mobile food facility (MFF), multi event vendor (MEV) or caterer names the commissary it will operate from, and the commissary owner confirms the facilities it provides. It is used by food operators who need a permit to operate and prepare or service their business at a commissary. On this page you can fill out the form online on FillingPDF and download or print the completed PDF; the form is published by the county at emd.saccounty.gov.
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What is Verification of Mobile Food Facility Commissary – Sacramento County, CA?
Verification of Mobile Food Facility Commissary is a Sacramento County Environmental Management Department form on which a mobile food facility, multi event vendor or caterer owner and a commissary owner confirm which commissary the business will use and which services it provides.\n\nThe form has three parts. The first page holds the business information, the owner's statement and the commissary information. In the statement, the owner agrees to report to the commissary at least once each operating day for cleaning and servicing (Calcode Sec. 114297), to store the vehicle, if applicable, at the approved commissary or another approved location, and to notify the Environmental Health Division at (916)875-8440 if the commissary is no longer used. The commissary owner or representative then signs that the facilities checked will be provided.\n\nThe back page is the MFF Menu and Food Preparation Questionnaire, which the form says is required for all new permit or renewal applicants. A separate Out of County Commissary page is used when the commissary is outside Sacramento County: a registered environmental health specialist (REHS) of the local department signs to verify a current health permit and that the facility meets CALCODE Section 114294-114297.\n\nThe form is a verification of a commissary. It does not by itself grant a permit; the commissary approval block at the bottom records Pending, Approved or Disapproved.
Who needs to file Verification of Mobile Food Facility Commissary – Sacramento County, CA?
Owners of the following businesses complete the first page of the form, naming the commissary they will operate from:\n\n- MEV (multi event vendor);\n- MFF Cat. A, Cat. B, Cat. C or Cat. D (mobile food facility);\n- Caterer.\n\nOwners of MFF Cat. B, C and D must also fill out the back page, the MFF Menu and Food Preparation Questionnaire, according to the form. The questionnaire is described as required for all new permit or renewal applicants.\n\nThe commissary owner or representative signs the commissary section. The commissary can be a commissary, MSU, restaurant, market or other facility, as the form lists. If the proposed commissary is outside Sacramento County, the Out of County Commissary page must be signed by an REHS of the local Environmental Health department.\n\nThe form is not for operators who have no commissary relationship to report; the form is built around the commissary or MSU named on it.
When to file Verification of Mobile Food Facility Commissary – Sacramento County, CA
The form accompanies your application for a permit: the commissary owner's signature must be a wet (original) signature made within 30 days of applying for the permit, and copies are not accepted. The MFF Menu and Food Preparation Questionnaire on the back page is required for new permit applications and for permit renewals.\n\nAfter the verification, timing obligations come from the owner's statement on the form: you report to the commissary at least once each operating day for cleaning and servicing, and you notify the Environmental Health Division at (916)875-8440 if you stop using the commissary so the necessary changes can be made. The form prints no processing time.
Documents you need
- MFF Menu and Food Preparation Questionnaire (back page of the form): required for MFF Cat. B, C and D, and described on the form as required for all new permit or renewal applicants.
- Out of County Commissary page signed by an REHS of the local Environmental Health department: needed only if the commissary is outside Sacramento County.
- Original (wet) signature of the commissary owner or representative: made within 30 days of applying for the permit; copies are not accepted.
How to fill out Verification of Mobile Food Facility Commissary – Sacramento County, CA
Enter permit reference numbers
At the top, enter the FA # and the PR# if you have them. These identify your facility and permit record with the department.
Select your facility type
Under MFF/MEV/Caterer Business Information, mark MEV, MFF – Cat. A, MFF – Cat. B, MFF – Cat. C, MFF – Cat. D or CATERER. Cat. B, C and D owners must also fill out the back page.
Enter business and owner details
Write the business name, license plate number (if applicable), owner name, mailing address, city, ZIP code, and work and mobile phone numbers.
Sign the owner statement
The MFF/MEV/Caterer owner signs and dates the statement agreeing to report to the commissary at least once each operating day and to notify the Environmental Health Division if use of the commissary stops.
Enter the commissary information
Mark the type of facility (Commissary, MSU, Restaurant, Market or Other), then enter the commissary business name, owner's name, address, city, ZIP code, contact phone and MFF access hours.
Mark the services provided
For each service listed, such as food preparation, sewage disposal, overnight parking, toilet and handwashing, potable water, warewashing, electrical hook-up, storage and garbage, circle Y or N.
Obtain the commissary signature
The commissary owner or representative signs and dates the statement that the checked facilities will be provided. The signature must be an original made within 30 days of applying for the permit; no copies.
Complete the menu questionnaire
On the back page, list menu items, cooking equipment on the truck and at the commissary, where food is prepared or cooked, where ingredients and supplies are stored, and comments. The MFF owner signs and dates it.
Use the out-of-county page if needed
If the commissary is outside Sacramento County, enter the MFF name, commissary name and address on the Out of County Commissary page and have the local REHS complete the county or city, name, REHS number, signature, date, phone and email.
Review and download the completed PDF
Check that every section matches the facility type and commissary named, then download or print the completed PDF from FillingPDF and collect the original signatures required.
How to submit Verification of Mobile Food Facility Commissary – Sacramento County, CA
The form does not name a delivery channel for the completed verification, so confirm how to submit it with the Sacramento County Environmental Management Department when you apply for your permit. The department's contact details printed on the form are:\n\n- Address: 11080 White Rock Road, Ste. 200, Rancho Cordova, California 95670\n- Fax: (916) 875-8513\n- Environmental Health: (916) 875-8440\n- Environmental Compliance: (916) 875-8550\n- Websites: www.saccounty.gov and emd.saccounty.gov\n\nThe form is listed among the Food Program Forms and Documents on the EMD website. Remember that the commissary owner's signature must be original (wet) and made within 30 days of applying for the permit; no copies are accepted. If the commissary is outside Sacramento County, include the Out of County Commissary page signed by the local REHS. FillingPDF lets you fill out and download the PDF; submission follows the agency's channels.
Common mistakes to avoid
- Submitting a copy of the commissary owner's signature; the form says the signature must be wet/original and that no copies are accepted.
- Using a commissary signature made more than 30 days before you apply for the permit.
- Skipping the back page questionnaire as an MFF Cat. B, C or D owner, although the form says these categories must fill it out.
- Naming a commissary outside Sacramento County without the Out of County Commissary page signed by the local REHS.
- Leaving the Y/N lines blank for services such as sewage disposal, potable water, warewashing or overnight parking instead of marking what the commissary provides.
- Using an unapproved facility for any of the listed purposes; the form warns it can lead to revocation of your permit to operate.
- Not telling the Environmental Health Division at (916)875-8440 when you stop using the commissary.
- Marking the wrong type of facility (MEV, MFF Cat. A to D or Caterer) at the top of the first page.
Frequently asked questions
What is the Verification of Mobile Food Facility Commissary?
It is a Sacramento County Environmental Management Department form on which a mobile food facility, multi event vendor or caterer owner names the commissary it will use, and the commissary owner confirms the services and facilities it provides.
Is this form a Sacramento County business license?
No. The form verifies the commissary used by an MEV, MFF or caterer; it does not issue a license or permit itself. The commissary approval block on it records Pending, Approved or Disapproved for the commissary.
Does the commissary owner have to sign in ink?
Yes. The form says the commissary owner's signature must be wet (original) and made within 30 days of applying for the permit. Copies are not accepted, so a scanned or photocopied signature will not meet the form's note.
Do I have to fill out the back page of the form?
MFF Cat. B, C and D owners must fill out the back page, the MFF Menu and Food Preparation Questionnaire. The form describes the questionnaire as required for all new permit or renewal applicants.
What if my commissary is outside Sacramento County?
Use the Out of County Commissary page. An REHS of the local Environmental Health department signs to verify the commissary has a current health permit and meets CALCODE Section 114294-114297, and adds the REHS number, date, phone and email.
What happens if I stop using my commissary?
Notify the Environmental Health Division at (916)875-8440 so the necessary changes can be made. The form also warns that using an unapproved facility for the listed purposes can lead to revocation of your permit to operate.
Can I fill out the commissary verification form online?
You can fill out the PDF online on FillingPDF and download or print it. FillingPDF does not file it with Sacramento County; you still need the original commissary signature and must submit it through the department's channels.
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