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SANJOAQU1N <br /> <br />Environmental Health Department <br />COUNTY-- <br />TEMPORARY FOOD VENDOR'S APPLICATION <br />All food vendors (both for profit and non-profit) are required to return a signed and completed copy of this checklist to <br />the festival coordinator three (3) weeks prior to this event <br />1. 1. Name of Event: Sacramento Kennel Club Date(s): April 11, 12, 13 & 14,2 <br />-00 9 2 The following is information about my organization/business: <br />Name of organization/business: Morada Eats <br />Address: 8436 Treasure Ave Stockton, CA. 95212 <br />Phone: (209 ) 931-9673 Alternate: ( <br />List food to be sold or given to the public: Bar B Q Ribs & Sandwiches <br />I am providing food that is NOT prepared at home: 12:1Yes Lii No <br />All food is prepared on-site or is from approved commercial facilities: [2] Yes 0 No <br />Name of facility: On-site Phone: ( ) <br />Address of facility: <br />I am providing a booth with the following: (to protect my unpackaged food and food-preparation areas from flies, <br />dust and the public) <br />E A booth with walls and ceiling constructed of either wood, canvas, plastic, similar material and fine mesh fly <br />screening, completely enclosing open food areas. It will also have a smooth and cleanable floor (concrete, <br />asphalt, clean tarps and smooth wood are acceptable) and constructed to separate food and food preparation <br />areas from the public. <br />V Other (specify): Food Truck <br />Note: The only operations not required to provide enclosed booths are those which sell beverages from <br />approved dispensers, or prepackaged foods from approved sources <br />Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods: <br />VI Approved bottled water. <br />2 On-site hose bib that is connected to a potable water source. <br />Li Other (specify): <br />Electricity is provided for my booth's use: g] Yes Eilll No <br />I am providing an accurate probe thermometer to measure the hot and cold holding of potentially hazardous <br />foods during all times of booth operation: VI Yes n No <br />I am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br />135°F: <br />0 Camp stove LI Sterno & hotel trays <br />2 Double steamer ['Steam table & lids <br />0 Electric stove top [I] Other (specify) <br />Note: Examples of potentially hazardous food include: meats, tamales, cooked beans, rice, <br />vegetables, potato salad, eggs, and dairy products. <br />1868 E. Hazelton Avenue Stockton, California 95205 I T 209 468-34201 F 209 464-0138 www.sjgov.oraiehd <br />EHD 16-02 Page 7 of 11 TEMP EVENT APP 06/19/19