Jackson County, MI · Jackson County
Food Establishment Plan Review Worksheet
Food establishment operators complete this worksheet with food safety, equipment, plumbing, storage, and facility details for a plan review.
At a glance
- Issued by
- City of Jackson County · Jackson County, Jackson County, Michigan
- Notarization
- Not required: file this form without a notary.
- Official source
- mijackson.org
- Blank form
- Download the PDF
- Catalogued
- Machine-readable
- JSON record · about the forms index
What this form is
Operators use this worksheet to provide information for a food establishment plan review. It asks about food preparation and handling, equipment, water and sewage, plumbing, storage, ventilation, and other facility details. Complete the sections that apply to the establishment and submit the worksheet to the local health department or Michigan Department of Agriculture regional office conducting the review; include supporting materials where the worksheet requests them.
Who needs it
Food establishment operators submit this worksheet when seeking a plan review from the local health department or Michigan Department of Agriculture regional office.
How to submit it
Submit the completed worksheet to the local health department or Michigan Department of Agriculture regional office conducting the plan review. Include requested supporting documents, such as copies of applicable food safety plans or a menu when the worksheet calls for one.
About notarization
This worksheet has no notary block and does not call for notarization; it does not identify a sworn attachment or related notarized step.
How to submit this form
- 1
Download the Worksheet
Download the Food Establishment Plan Review Worksheet PDF.
- 2
Complete Applicable Sections
Provide the establishment details and answer the applicable questions about food handling, equipment, plumbing, storage, and facility plans.
- 3
Gather Requested Materials
Attach supporting documents, such as food safety plans or a menu, when requested by the worksheet.
- 4
Submit for Plan Review
Send the completed worksheet to the local health department or Michigan Department of Agriculture regional office conducting the review.
Frequently asked questions
- What is the Food Establishment Plan Review Worksheet?
- It is a worksheet for operators to provide food safety, equipment, plumbing, storage, and facility information for a food establishment plan review.
- Who submits this worksheet?
- The food establishment operator completes and submits it to the local health department or Michigan Department of Agriculture regional office conducting the plan review.
- Do I need a notary for the Food Establishment Plan Review Worksheet?
- No. The worksheet has no notary block and does not call for notarization; it does not identify a sworn attachment or related notarized step.
- How do I submit the Food Establishment Plan Review Worksheet?
- Submit it to the local health department or Michigan Department of Agriculture regional office conducting the plan review. Include supporting documents or a menu when the worksheet requests them.