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Environmental Health Department Initial next to the below statements Indicating that you understand and will abide by them. M 1 2 3 4 5 6 7 8 9 10 w 11 Trtfe Print Name: Statements 4. Cleaning- Describe the procedures you will use to clean and sanltlte food contact surfaces, equipment, and utensils at the commissary. A Catering permit may be used to prepare and serve food at private events and host facilities only. Operating at a Community Event or Certified Farmers' Market requires a separate health permit. All food must be prepared at the approved facility. Home preparation of food Is prohibited. Only limited food preparation, as defined in California Retail Food Code (CRFC), is allowed at an off-site food service event. SANJOAQUIN COUN1Y When operating at an off-site food service event, a sign or business cards must be posted/provided at the event premises stating the Caterer's business name and address. All equipment, utensils and food related items shall not be stored in a private home when not conducting catering activities. Upon request, you must provide your operation schedule to EHD for inspection purposes. NOTE: Operation at Host Facilities limited to four (4) hours in a twelve (12) hour period. Mechanical refrigeration is required to hold all potentially hazardous food during operation; use of ice, portable cooling blocks, or ice chests/coolers is prohibited._________________________________ At the end of the operational period, all multi-use utensils will be washed and sanitized at the approved commissary. Have access to potable water. All garbage, refuse and liquid waste will be disposed of in an approved manner as approved by the EHD. ____________________________________________________ At the end of the operational period, all multi-use utensils will be washed and sanitized at the approved commissary/permitted food facility._ ___________________________ Any food that has become contaminated, suspected of becoming contaminated or presumed unsafe must be discarded. approvals are obtained frop»-il Authorized Signature: Indicate the specific sanitizer or sanitizing method that you will use by checking the box below: (R'Contact with a solution of 100 ppm (parts per million) available chlorine for at least 30 seconds. Contact with a solution of 200 opm available quaternary ammonium for at least one (1) minute. Check the option you will use: HCommercial pre-mixed solution or^^will prepare my own sanitizer solution _____________________Acknowledgment_______________________________ I understand and agree that i I make changes to my operating procedures. I must notify the EHD within 7 days FaAire to notify EHD of any changes may resuK in suspension or revocation of the Health Permit issued to me to operate as a Catering Operaboo Ensure approvals are obtained trop»-al applicable agencies prior to operation (e g., fire, zoning, etc.). Date: ^1- A