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; <br /> __Wpm, ` SAKOAQUIN Environmental Health Department <br /> t� COUNTY <br /> Greatness grows here. <br /> Catering rr • Operating • • ` <br /> All documents listed below must be submitted to the San Joaquin County Environmental Health Department <br /> (EHD) prior to beginning catering operations. A field consultation will also be conducted at the proposed <br /> commissary to verify that the location is suitable for your catering functions. A signed copy of this document as <br /> well as your Environmental Health permit must be maintained with your Catering Operation during all operating <br /> hours. <br /> Please note that any changes to the menu,equipment,or procedures listed on the approved form will require <br /> approval by EHD. <br /> f� <br /> Catering Operation Name: l Ao k tow,, gkw6eczte Facility ID#: <br /> Business Owner Name: ���� C►G�► CGin 1' Phone #: 340 SZ I cf(2 7 <br /> E-mail: Website(if applicable) <br /> Mailing Address: T eveX Lil City: Zip Code: q5S oq <br /> Documents • Include <br /> ✓ Check the following items as you include them with this document. <br /> Application-Complete and submit the Service Request form. Ensure that all information is legible. <br /> mmissaryAgreement-The Caterer must prepare and store all food and equipment ata commissary kitchen <br /> (permitted food facility).The Caterer and their proposed commissary must complete and sign the commissary <br /> agreement.Caterers are subject to limited food preparation only(HSC 113818(a)(4))when conducting direct- <br /> ales at a host facility. <br /> Specification Sheets- Submit specification or cut sheets for your equipment, including the portable <br /> mechanical refrigeration, overhead protection/enclosure, and portable hand-washing sink(s) carts that will <br /> ❑ <br /> be utilized during a Catering event. Provide documentation that shows the certification for sanitation and <br /> electrical standards by an American National Standards institute(ANSI)accredited certification program such <br /> s NSF, UL, ETL,etc.for food equipment. <br /> Menu-Include any menus. List all food and beverages items to be sold. (Refer to page 2&5) <br /> Food Protection Manager Certification-Provide proof that an owner or employee has a valid Food Manager <br /> certificate. <br /> Food Handler Card-Provide documentation that all employees have a valid California Food Handler Card. <br /> Log-A written log must be maintained for a minimum of 90 days after each operation to include the event <br /> organizer name and contact information, location of service, menu of foods and beverages served. When <br /> Aerating at a host facility, the log shall include your menu and location/date/time of operation. Please <br /> describe how you will log this information (i.e.What type of database) and provide a sample of that log. <br /> 1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/ehd <br />