Odh Form 824 PDF Details

Navigating the complexities of establishing or renovating a food or lodging establishment involves a multitude of steps, with one of the first and most critical being the submission of the Odh 824 form to the Consumer Protection Division at the Stephens County Health Department in Duncan, Oklahoma. Designed as a Plan Review Application, this form is foundational in the process towards acquiring the necessary permissions for operation. It emphasizes the non-negotiable requirement for all establishments to undergo a thorough inspection and secure a license prior to initiating service. Applicants are required to provide detailed information including the establishment’s name, location, and the contact details of the applicant. Moreover, the form delineates clear directives on ownership type, construction specifics, and requisite identifiers such as State Tax ID or Federal ID numbers. Importantly, the application process, with a stated fee of $200, underscores a commitment to consumer protection and public health by ensuring that all food service, food manufacturing, or lodging operations adhere to established standards prior to their operation. Additionally, the form facilitates a comprehensive review by requiring submissions of plans and specifications, ranging from layout and equipment details to intended menus and anticipated food volumes, thereby ensuring every aspect of the establishment’s operation is scrutinized for compliance and safety.

QuestionAnswer
Form NameOdh Form 824
Form Length4 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min
Other namesspecifying, DEQ, Duncan, OAC

Form Preview Example

Consumer Protection Division

Remit this form with fee and plans to:

Stephens County Health Department

1401 Bois D’Arc

Duncan, OK 73533

PLAN REVIEW APPLICATION FOR A FOOD OR LODGING ESTABLISHMENT

(This is not a license to operate)

Establishment Name: ____________________________________________________/_______________________________________

County

Street Address: ______________________________________________________City:________________________St:_______Zip:___________

APPLICANT INFORMATION - Complete the FollowingE-Mail Address:_________________________________

Cell phone:_____________________

Applicant Name:______________________________________________________________Telephone:______________________

Applicant Address:_____________________________________________________________________________________________________

Applicant City, State, Zip:______________________________________________________________________________________________

CONTACT INFORMATION IF DIFFERENT:

Cell phone:__________________________

Contact Name:______________________________________________________________Telephone:_______________________

Contact Address:_____________________________________________________________________________________________________

Contact City, State, Zip:________________________________________________________________________________________________

Type of Ownership: Individual Partnership Corporation L.L.C

If Applicable: State Tax ID #___________________________ and/or Fed ID #____________________________

Type of Construction:

New Construction (including new seasonal and new mobile establishments).

Remodel of existing food service establishment.

Conversion of existing structure for use as a food establishment.

Existing establishment which changes the type of operation.

(Temporary food establishments are exempt from plan review and will be evaluated for compliance on site.)

HEALTH DEPARTMENT USE ONLY

Date Copies of Rules Received_______________

OAC 310:225

________owner

OAC 310:240

 

OAC 310:257

______manager

OAC 310:260

 

OAC 310:285

 

Date Received: ______/______/______

Receipt #: ________________________

White Copy - OSDH

Yellow Copy - Applicant &/or City License App. Pink Copy - County Health Dept.

This Application must be submitted with the Fee of $200.00 made payable to the local County Health Department where establishment will be located. The application must be completed in full. All facilities must be inspected and licensed prior to operation. Completion and submission of this form does not constitute authorization to open a food service, warehouse, processor, drug manufacture or lodging establishment. THIS FEE IS NON-REFUNDABLE.

NOTE: Plans and Equipment Schedule must be submitted with this application.

Applicant Signature/Title/Date

DO NOT SEND CASH !! SEND CHECK OR MONEY ORDER ONLY

Submit this application, plans, and payment to the local County Health Department.

(If this form is down-loaded, please submit in triplicate).

Oklahoma State Department of Health

ODH Form # 824

Protective Health Services

(Rev. 07/2008)

Consumer Protection Division

 

Instructions for Application and Fee Submission

(This is not a license to operate)

A person may not operate a food service, manufacturing or lodging establishment without a valid license to operate, issued by the regulatory authority. A person desiring to operate an establishment shall submit to the Oklahoma State Department of Health (respective County Health Department in which the establishment shall be licensed) a Plan Review Application on Form # 824 along with the application fee and plans. This process allows us to assist you from the beginning and to use your resources wisely. The consultation that we provide will help eliminate costly mistakes in the construction, conversion or purchase of the establishment.

A.Applications for Plan Review shall be submitted for:

New Construction (where no current license exists). - Includes new seasonal and new mobile establishments.

Remodel of existing food service establishment.

Conversion of existing structure for use as a food establishment.

Existing establishment which changes the type of operation.

B.Submission of the application shall include:

1.The name, mailing address, telephone number(s), approximate number of employees, and signature of person applying for the license and the name, mailing address and location of the establishment. The Plan Review Fee shall be included with submission of the Application Form # 824.

2.Information specifying whether the establishment is owned by an individual, partnership, corporation, or other legal entity, State and/or Federal ID #'s, if applicable and type of construction (ie. new, remodel, conversion).

3.Signature and date of applicant.

4.Plans and specifications.

C.Contents of plans and specifications shall include:

1.The proposed layout or floor plan, including location of equipment, sinks, etc. (should be drawn to scale or indicate dimensions);

2.The intended menu and the anticipated volume of food sold, stored, prepared or served,

(if applicable);

3.Proposed equipment types, manufacturer and model numbers (if available); and

4.Other information that may be required by the Department for the proper review of the proposed construction, conversion or modification, and procedures needed for operating an establishment in the respective license classifications. (ie. finish schedule, plumbing, mechanical, construction material, etc.).

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1000 NE 10th St., P. O. Box 268815

Oklahoma City, OK 73126-8815

Telephone 405/271-5243 Fax 405/271-3458

OK.gov/health

LODGING ESTABLISHMENT PLAN REVIEW APPLICATION GUIDELINE

NEW

(Please complete all applicable sections)

CONVERSION

REMODEL

Name of Establishment:________________________________________________________

Number of guest rooms:________________________________________________________

Establishment Address:_________________________________________________________

Contact Phone and Name:________________________________________________________

Name of Owner:_______________________________________________________________

Owner’s Mailing Address:_______________________________________________________

Owner’s Telephone:____________________________________________________________

Owner’s Email Address:_________________________________________________________

Applicant's Name:______________________________________________________________

Title (owner, manager, architect, etc.):______________________________________________

Applicant’s Mailing Address:_____________________________________________________

Applicant’s Telephone:__________________________________________________________

Applicant Email Address:________________________________________________________

1.Projected Date for Start of Project: _______________

2.Projected Date for Completion of Project: _______________

3.It is recommended that plans be drawn to scale or have dimensions indicated. Plans should be submitted at a minimum of a 8.5 X 11 sheet of paper.

4.Finish schedule of surfaces for floors, walls, ceilings, and food storage/prep areas.

5.Laundry room detail including equipment and provisions for storage of clean and soiled items.

6.Location and type of ice machines. (Note: Ice machines for customer self service shall be automatic dispensing in a manner which eliminates the possibility of contact except for that portion being dispensed.) If the operator will dispense ice, please describe in detail.

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7.Location and manner for refuse disposal.

8.Water Supply

A.Is the water supply public ( ) or non-public/private ( ) ?

B.If private, has source been approved? YES ( ) NO ( )

Attach copy of written approval and/or permit from DEQ (or provide prior to opening).

9.Sewage Disposal

A.Is the sewage system public ( ) or non-public/private ( ) ?

B.If private, has sewage system been approved? YES ( ) NO ( )

Attach copy of written approval and/or permit from DEQ (or provide prior to opening).

10.Documentation from the Fire Code Official having jurisdiction for compliance with Life Safety Code 101. The Authority Having Jurisdiction (AHJ) will normally be the Fire Marshall for the municipality where the establishment is located. If there is no local AHJ then the document must be from the State Fire Marshall’s Office.

11.If limited food will be provided as authorized by the lodging regulations, provide a floor plan indicating the location and types of equipment, sinks, finish schedule, storage areas, a detailed description of the foods and beverages to be provided, and a description of any preparation required by the operator or customer. The limitations for food service under a lodging license are found in section 310:285-3-14. Note: If equipment requiring warewashing or multi-use utensils are provided either in the guest rooms or food service area, facilities shall be provided for warewashing as provided in the lodging rules.

12.Affidavit of Lawful Presence by owner if individual ownership.

13.If this lodging establishment will have a swimming pool or spa, please submit an application with plans to the Oklahoma State Department of Health for a public bathing place in accordance with Chapter 315, Public Bathing Place Facility Standards.

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