Environmental Health inspection report

• Conducted on

  Date

• Client/Site

• Business address
  Address

Business Details

• Full name of food business operator

• Full name of food business proprietor

• Head Office

• Registered Office

• Business Type

Intervention Details

• Select date

  Date

• Intervention type

• Food law under which intervention conducted:-
  The European Communities Act 1972
  Food Safety Act 1990
  Food Hygiene (England) Regulations 2013
  General Food Regulations 2004
  Regulation (EC) No. 178/2002
  Regulation (EC) No. 852/2004

• Other:-

• Areas inspected

• Photos of area/s if required

  Media

• Name/s of person/s seen and/or interviewed

• Documentation and/or other records examined

• Samples taken

• Key points discussed

• Actions to be taken by the Food and Safety Authority

Key points discussed

• Legal

• Recommendations

Local Authority

• Mid Sussex District Council

• Signature

  Sign

• Name in capitals

• Designation

  Senior Environmental Health Officer

  Food Safety Officer

• Contact details of inspecting officer

• Phone

• Fax 01444 477366

• Email: foodsafety@midsussex.gov.uk

• Food authority name and address

• Food & Safety Team
  Environmental Health
  Mid Sussex District Council
  Oaklands
  Oaklands Road
  Haywards Heath
  West Sussex
  RH16 1SS

• Contact details of Food Safety Team Leader (in case of dispute)

• Mrs Elaine Jowett

• Telephone 01444 477295

• Fax 01444 477366

• Email: foodsafety@midsussex.gov.uk

Food business operator/representative signature

• Signature

  Sign

• Name in capitals

• Select date

  Date