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SAN JOAQUIN <br />couN-y <br />Environmental Health Department <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. Name of Event: Ganesh Utsav Date(s): 9/14/2024 <br />The following is information about my organization/business: <br />Name of organization/business: Egglicious India LLC <br />Address: 4996 Stevens Creek Blvd San Jose CA 95129 <br />Phone: ( 669)301 3801 <br /> <br />Alternate: ( 408) 605 3837 <br /> <br />List food to be sold or given to the public: Pay Bhaji, Vada Pay, Misal Pay, Sabudana Vada <br />I am providing food that is NOT prepared at home:V4i'es El No <br />All food is prepared on-site or is from approved commercial facilities: es El No <br />Name of facility: Egglicious India Phone: ( 669)301 3801 <br />Address of facility: 4996 Stevens Creek Blvd San Jose CA 95129 <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 />VA 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 />E Other (specify): <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 />Approved bottled water. <br />El On-site hose bib that is connected to a potable water source. <br />E Other (specify): <br />Electricity is provided for my booth's use:VYes El No <br />I am providing an accurate probe thermomej to measure the hot and cold holding of potentially hazardous <br />foods during all times of booth operation: !.IV; Yes El No <br />I am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br />135°F: <br />CI Camp stove El Sterno & hotel trays <br />E Double steamer VSteam table & lids <br />El Electric stove top El Other (specify) <br />Note: Examples of potentially hazardous food include: meats, tamales, cooked beans, rice, <br />vegetables, potato salad, eggs, and dairy products.