Laserfiche WebLink
Environmental Health Department <br />2. <br />3. <br />4. <br />5. <br />6; <br />I <br />I <br />SiNJOAOUIN <br />y ------COUNTY------ <br />Greatness grows here. <br />TEMPORARY FOOD VENDOR’S APPLICATION <br />- - -tk"\ <br />r- ./p , • *■ . ' >* <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:Lo A' Date(s): <br />The following is information about my organization/business: <br />Name of organlzation/business: <br />Address: S'' <br />Phone: 7^/ ( ) <br />List food to be sold or given to the public: /, <br />I am providing food that is NOT prepared at home: g Yes No <br />All food is preparedoQ-site or is from approved commercial facilities: S Yes Q No <br />Name of fee lily: ZlYaS-A/cZ Phone: (^) SSC>' <br />Address of <br />I am providing a w^h the following: (to protect my unpackaged food and'food-preparation areas from flies, <br />S?A booth with walls and ceiling constructed of either wood, canvas, plastic, similar material and fine mesh fly <br />keening xxjnipletely enclosing open food areas. It will also have a smooth and cleanable floor (concrete, <br />are^fr' rrV^C an^ smooth wood are acceptable) and constructed to separate food and food preparation <br /> . _ <br />Note: The onty’ operatibns not required to pmvido enclosed booths are those which sell beverages from <br />; • ..^^.erprep^ <br />hand washing will be provided in my booth by the following methods. <br /> . W : Z7 --------- --------- <br />tOp^easLJre ‘he t10t ana co!d ,lc,,diiig of potent al y hazardous <br />a of, t,azardoi:s foads ato/u <br />; in Double sfeamer Usteani table,& lids I; <br /> (^cfecstoveW tlOlher (specify) . . <br />Note: Examples of potentially hazardous food include: meats, 'tamales, cooked beans, rice, <br />vegetables, potato salad, eggs, and dairy products. ■ <br />g^^;Haze,tOf1 Avenue j Stocktun. California 95205 | T 209 468-3420 <br />05'20/2023 f’a30 7o'11