Laserfiche WebLink
rV,� lq <br /> S A N D OAQ U I N 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 (73)/w�eeekks prior to this event. <br /> 1. 1.Name of Event: ^ ✓��" �C1 Date(s):A j <br /> 2. The following is information about my organizationlbusiness: <br /> Name of organization/business: <br /> Address: i3. /_Z0Z <br /> Phone: (,�Iexp Alternate: ('10-I <br /> I List food to be sold or given to the public: r/1N�, Fr 1V1q e- P->'CC P4->4T£ <br /> 4 1 am providing food that is NOT prepared at home: ❑ Yes [�rNo <br /> All food is prepared on-site or is from approved commercial facilities: Yes ❑ No <br /> Name of facility: Phone; <br /> Address of facility: <br /> 5. 4 am providing a booth with the following: (to protect my unpackaged food and food-preparation areas from flies. <br /> dust and the public) <br /> /QUA 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 /> ❑ Other (specify): <br /> Note: The only operations not required to provide enclosea booths are those which sell beverages from <br /> approved dispensers. or prepackaged foods from approved sources. <br /> 6. Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods: <br /> Approved bottled water. <br /> ❑ On-site hose bib that is connected to a potable water source. <br /> ❑ Other(specify): <br /> 7. Electricity is provided for my booth's use: Yes ❑ No <br /> 8. 1 am providing an accurate probe thermometer to measure the hot and cold holding of potentially hazardous <br /> foods during all times of booth operation: Z'Yes ❑ No <br /> 9. 1 am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br /> 135'F: <br /> ❑ Camp stove ETSterno & notel trays <br /> ❑ Double steamer 2 steam table & lids <br /> ❑ E=ectric stove top ❑'Other (specify) Hf�AT LAM� <br /> Dote: Examples of potentially hazardous food include: meats, tamales, cooked beans, rice, <br /> vegetables, potato salad, eggs, and dairy products. <br /> 1868 E. Hazelton Avenue G Stock*on, California 952CS I T 209 468-3420 l F 209 464-0138 1 %Ww.sjgov.orglehd <br /> vgca .` TEMP E`JENT APP <br /> EHD 1&02 <br />