Home Services Consumer Health Emergency Reporting Form Home Services Consumer Health Please complete the information below to allow the Houston Health Department Bureau of Consumer Health Services (BCHS) to plan inspections and assist you in reopening your establishment as quickly as possible. City of Houston Food Establishment Number Establishment Name Address Address City/Town State/Province - None -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle East)Armed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederated States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyomingAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNova ScotiaNorthwest TerritoriesNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon ZIP/Postal Code Contact Name Contact Phone Number E-mail Alternate Contact Name Alternate Phone Number Establishments with a BCHS-Accepted Plan for operating during an extended power or water outage Please note: You are required to immediately stop all food-related operations including food preparation and handling, ware washing, and cleaning of utensils/equipment and the premises if one or more of the following imminent health hazards exists: an extended electrical outage (over 4 hours)* an interruption in water service (water outage over one hour/no hot water/Boil Water Notice)* flooding sewage water backup fire structural damage or similar event that might result in the contamination of food or prevent time and temperature controlled for safety (TCS) food from being held at required temperatures You must cease all operations due to any sewage backup in the establishment and request an inspection for full or partial resumption of operations. (Refer to Ready to Re-Open below.) You may continue operations in an area of your establishment that is unaffected by flooding or structural damage as long as all food safety requirements can be met. * You may continue to operate your establishment with an extended electrical outage and/or an interruption in water service if you follow your BCHS-accepted plan for electrical outages and water service interruptions. Please check the appropriate boxes. If your establishment is open for business: Establishment is operating under a current BCHS-Accepted Emergency Preparedness Plan for (check all that apply): BCHS- Accepted Emergency Preparedness Plans for: No Electricity No Water No Hot Water Boil Water Notice Establishment has ceased operations in the following confined areas (enter text below) due to the condition(s) checked below but remains open in the unaffected areas of the establishment. Establishment is fully operational and was not affected by an imminent health hazard Confined Areas If your establishment or a confined area of your establishment is closed: Date closed Closed due to (check all that apply) Loss of electricity Loss of water Loss of hot water Boil Water Notice Flooding Sewage Backup Fire Damage inside/outside facility* Other… Enter other… *Contact the Houston Permitting Center for approval/permits to replace large, floor-mounted equipment, repair/replace interior surfaces, and/or repair, reconstruct, or remodel the facility’s structure. If your establishment is Ready to Re-open, check the box applicable to your establishment’s current situation: Establishment has been operating under a current BCHS-accepted emergency preparedness plan for an extended power outage and/or interruption in water service and is resuming normal operations. Establishment may reopen without waiting for approval from BCHS. Establishment discontinued all food-related operations in the establishment or a confined area of the establishment and now requests approval to re-open the establishment/confined area after meeting the Requirements to Resume Normal Operations. BCHS will contact you to discuss scheduling an inspection. Please ensure that the contact information above is correct. Establishment requests a pre-opening inspection after: (1) receiving approval and/or permits from the Houston Permitting Center; (2) completing work as required; and (3) meeting the Requirements to Resume Normal Operations. BCHS will contact you to discuss scheduling a pre-opening inspection. Please ensure that the contact information above is correct. Comments Establishments that do not have a BCHS-Accepted Plan for operating during an extended power or water outage Please note: You are required to immediately stop all food-related operations including food preparation and handling, ware washing, and cleaning of utensils/equipment and the premises if one or more of the following imminent health hazards exists: an extended electrical outage (over 4 hours) an interruption in water service (water outage over one hour/no hot water/Boil Water Notice) flooding sewage water backup fire structural damage or similar event that might result in the contamination of food or prevent time and temperature controlled for safety (TCS) food from being held at required temperatures You must cease all operations due to any sewage backup in the establishment and request an inspection for a full or partial resumption of operations. (Refer to Ready to Re-open below.) You may continue operations in an area of your establishment that is unaffected by flooding or structural damage as long as all food safety requirements can be met. Please check the appropriate boxes. If your establishment is open for business: Establishment is fully operational and was not affected by an imminent health hazard. Establishment has ceased all operations due to the condition(s) checked below. Establishment has ceased operations in the following confined areas (enter text below) due to the condition(s) checked below but remains open in the unaffected areas of the establishment. Confined Areas If your establishment or a confined area of your establishment is closed: Date closed Closed due to (check all that apply) Loss of electricity Loss of water Loss of hot water Boil Water Notice Flooding Sewage Backup Fire Damage inside/outside facility* Other… Enter other… *Contact the Houston Permitting Center for approval/permits to replace large, floor-mounted equipment, repair/replace interior surfaces, and/or repair, reconstruct, or remodel the facility’s structure. If your establishment is Ready to Re-open (check the appropriate box): Establishment requests approval to conduct the following operations during an electrical outage and/or interruption in water service and no other imminent health hazard exists (check all that apply): Operations sell only pre-packaged non-TCS (time and temperature control for safety) food operate using a generator operate using a source of water other than the City of Houston public water supply. Describe the source below Description of Other Water Source Establishment discontinued all food-related operations in the establishment or a confined area of the establishment and now requests approval to re-open the establishment/confined area after meeting the Requirements to Resume Normal Operations. Establishment requests a pre-opening inspection after: (1) receiving approval and/or permits from the Houston Permitting Center; (2) completing work as required; and (3) meeting the Requirements to Resume Normal Operations. Comments Questions? Contact BCHS at CHS@houstontx.gov or (832) 393-5100. Houston Permitting Center (for approval/permits to replace large, floor-mounted equipment, repair/replace interior surfaces, and/or repair, reconstruct, or remodel the facility’s structure.) 1002 Washington, Houston 77002 (832) 394-8810 Office Hours 8 am-4:30 pm www.houstonpermittingcenter.org Leave this field blank Page last reviewed: February 7, 2024
