Application for Mobile Food Service Businesses (Providence, Rhode Island)

This is the official Application for Mobile Food Service Businesses from Rhode Island Department of Health, Center for Food Protection. You can fill it in its original layout in your browser or with an AI assistant, then download it to review, sign and submit to the agency.

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Form details

Issuer: Rhode Island Department of Health, Center for Food Protection
Jurisdiction: Providence, Rhode Island
Type: Food truck and mobile vending permits
Questions: 185
Last mapping review: 2026-10-02

Official blank PDF from Rhode Island Department of Health, Center for Food Protection ↗

What this form asks

Supporting Documents Included: Construction Application (checkbox)
Supporting Documents Included: Lease Agreement (commissary or incubator kitchen) (checkbox)
Supporting Documents Included: Food Processor Retail (FPR) License (checkbox)
Supporting Documents Included: Non-Profit 501(c) Documentation (checkbox)
Supporting Documents Included: Menu of all foods that will be served (checkbox)
Name of Business (Doing Business As)
Previous Business Name & License Number (if any) for Mobile Unit
Mobile Food Service Business Type (choose one)
3. Business Contact Person: Name
3. Business Contact Person: Phone Number
3. Business Contact Person: Email Address
4. Business Mailing Address: Address Line 1
4. Business Mailing Address: Address Line 2
4. Business Mailing Address: Address Line 3
4. Business Mailing Address: City
4. Business Mailing Address: State
4. Business Mailing Address: Zip Code
4. Business Mailing Address: Phone Number
4. Business Mailing Address: Fax Number
4. Business Mailing Address: Email Address
5. Location: Address Line 1
5. Location: Address Line 2
5. Location: Address Line 3
5. Location: City
5. Location: State
5. Location: Zip Code
5. Location: Phone Number
5. Location: Fax Number
5. Location: Email Address
6. Ownership Type (write-in, optional)
6. Ownership Type (check one) (choose one)
6. Entity/Owner Name (list only one)
6. DBA (Doing Business As)
6. Owner Address: Same as mailing address in #4 (checkbox)
6. Owner Address: Same as location address in #5 (checkbox)
6. Owner Address: Address Line 1
6. Owner Address: Address Line 2
6. Owner Address: Address Line 3
6. Owner Address: City
6. Owner Address: State
6. Owner Address: Zip Code
6. Owner Address: Country (only if not in USA)
6. Owner Address: Email Address
6. Owner Address: Phone Number
6. Owner Address: Fax Number
7. Vehicle Registration State
7. Vehicle Registration Plate
Primary Food Safety Manager 1: Name
Primary Food Safety Manager 1: FMC #
Primary Food Safety Manager 2: Name
Primary Food Safety Manager 2: FMC #
Printed Name of Authorized Person
Title of Authorized Person
Date of Signature (date)
9. SSN/FEIN #
Trucks, Trailers, Carts: Name on License Application
Trucks, Trailers, Carts: Menu (attach to application)
Trucks, Trailers, Carts: Will you be using a commissary?
Trucks, Trailers, Carts: If yes, which commissary (please attach lease agreement)
Trucks, Trailers, Carts: Name of Certified Food Safety Manager
Trucks, Trailers, Carts: Where will food be purchased?
Trucks, Trailers, Carts: Describe handwashing set up
Trucks, Trailers, Carts: 3-bay sink on truck, please describe
Trucks, Trailers, Carts: What is the source of potable water? (choose one)
Trucks, Trailers, Carts: Describe hot and cold running water capability
Trucks, Trailers, Carts: What sanitizer will you be using?
Trucks, Trailers, Carts: Where will wastewater be discharged?
Trucks, Trailers, Carts: Describe material for food contact surfaces
Trucks, Trailers, Carts: Explain where available toilet facilities
Trucks, Trailers, Carts: Explain trash removal procedures
Trucks, Trailers, Carts: What is ceiling made of?
Temporary Event Vendor: Name on License Application
Temporary Event Vendor: Menu (attach to application)
Temporary Event Vendor: Events that you plan on attending
Temporary Event Vendor: Will you be preparing food onsite? (multiline)
Temporary Event Vendor: Where will food be purchased?
Temporary Event Vendor: Name of Certified Food Safety Manager
Temporary Event Vendor: Please describe how food will be transported
Temporary Event Vendor: What will be used to keep food frozen?
Temporary Event Vendor: Describe handwashing set up
Temporary Event Vendor: What will be used to prevent bare hand contact?
Temporary Event Vendor: 3 bay sink for washing, rinsing, sanitizing: Please describe
Temporary Event Vendor: What sanitizer will you be using?
Temporary Event Vendor: Overhead protection: Please describe how food is protected
Temporary Event Vendor: Please describe how food will be stored
Temporary Event Vendor: Will you be using a licensed facility to prepare and hold food? Please name facility
Food Safety Plan: All employees understand and have signed an employee illness agreement (choose one)
Food Safety Plan: Employee illness agreement: details
Food Safety Plan: Sick employees are instructed to (multiline)
Food Safety Plan: Clean up kit assembled and available (choose one)
Food Safety Plan: Clean up kit: details
Food Safety Plan: Written procedure for cleaning vomit and diarrhea: details
Food Safety Plan: The establishment has a written procedure for cleaning vomit and diarrhea (choose one)
Food Safety Plan: Employees will wash their hands whenever (multiline)
Food Safety Plan: Gloves / bare hand contact: details
Food Safety Plan: When handling ready-to-eat food, employees will wear gloves and avoid bare hand contact (choose one)
Food Safety Plan: Employee personal belongings will be kept (multiline)
Food Safety Plan: Employee will only eat in
Food Safety Plan: RIDOH-Certified Food Safety Managers: NA (checkbox)
Food Safety Plan: Certified Food Safety Manager 1: Name
Food Safety Plan: Certified Food Safety Manager 1: FMC Number
Food Safety Plan: Certified Food Safety Manager 1: Expiration (MM-DD-YYYY) (date)
Food Safety Plan: Certified Food Safety Manager 2: Name
Food Safety Plan: Certified Food Safety Manager 2: FMC Number
Food Safety Plan: Certified Food Safety Manager 2: Expiration (MM-DD-YYYY) (date)
Food Safety Plan: Certified Food Safety Manager 3: Name
Food Safety Plan: Certified Food Safety Manager 3: FMC Number
Food Safety Plan: Certified Food Safety Manager 3: Expiration (MM-DD-YYYY) (date)
Food Safety Plan: This establishment sources food from the following (multiline)
Food Safety Plan: Cold foods must be received at (°F) (number)
Food Safety Plan: Cold food receiving temperature: NA (checkbox)
Food Safety Plan: Hot foods must be received at (°F) (number)
Food Safety Plan: Hot food receiving temperature: NA (checkbox)
Food Safety Plan: Corrective action at receiving if food is damaged, temperature abused, or otherwise not safe (multiline)
Food Safety Plan: Cold Holding: NA (checkbox)
Food Safety Plan: Refrigerated units are maintained at (°F or below) (number)
Food Safety Plan: Refrigerator thermometers: details
Food Safety Plan: All refrigerated units are provided with accurate thermometers (choose one)
Food Safety Plan: Corrective action if refrigeration temperature is above 41°F (multiline)
Food Safety Plan: Date Marking: NA (checkbox)

…and 65 more.

Review, sign and submit

PaperPorter fills the form but does not submit it or approve anything. Signatures, initials and staff-only areas are left for the right person. Confirm current fees, attachments and filing instructions with Rhode Island Department of Health, Center for Food Protection.

Other Providence forms

Application for Construction Rhode Island Department of Health, Center for Food Protection

Food truck and mobile vending permits in other places

Frequently asked questions

Does PaperPorter submit this form?

No. You download the completed PDF, then review, sign and submit it to Rhode Island Department of Health, Center for Food Protection yourself.

Can I fill it without an AI assistant?

Yes. Fill it in your browser and download the completed PDF. An assistant such as ChatGPT or Claude can also ask you the questions and fill it for you.