Laserfiche WebLink
Y <br /> SAKJOAOUIN <br /> Environmental Health Department <br /> —CCDUNTY- <br /> 6rrntr,r,t rrr <br /> TEMPORARY FOOD VENDOR'S APPLICATION <br /> Al food vendors (,both for profit and non-profit; are required to return a sigred and completed copy of this checklist to <br /> the festival coordinator three 13}weeks ardor tc,this event_ <br /> 1_ '.Name of Event taste of soul Date(s�,. 8/12/2024 <br /> 1- The following is informat,on about my o rganizatpxvbusiness: <br /> Name of organizalion-'business: howard gumbo <br /> �r�ss: 1600 dell Campbell ca, 95008 <br /> Phone: 1 408.1 4213558 Alternate <br /> k_ List food to be sad or giver,tomep,lbbc_ seafood gumbo, gumbo fries, fried catfish <br /> 4 1 am arovdtng food that is NOT prepares at home: n Yes❑ No <br /> All food is prepared on-site or is from approved commeroal facilities. [3 Yes❑No <br /> Name of faolay: mr.. C's kitchen Phone:f 895 610-3808 <br /> Address of iaalrty- 1600 dell ave Campbell ca 95008 <br /> 5- 1 am providing a booth-with the following: (to protect my unpackageC fcc•d and food-preparation areas from fees. <br /> dust and the Dublr_I <br /> [I A booth with walls and ceding constructed of either SNOod. canvas.clastic. similar matenal anc fine mesh fly <br /> screening. completely enck.ing open food areas. I will also ha,.* a smooth and cleanarjle floor icorcrete. <br /> asphalt. clean tarps and smooth woos are acteptaolei anc constructed to separate food anc food preparaton <br /> areas from the aublic. <br /> ❑Other(swityl <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 /> 5- Approved water for drinking. utensil ard hand washing will be provided in my,booth by the following meths <br /> [3 Approved bottled water. <br /> ❑On-site hose bib that is connected to a pbtatle water source. <br /> (3 Other l;speecify)_ potable water <br /> 7_ Electricity m provided for my booth's use: Yes No <br /> 8_ 1 am proving an accurate probe thermometer to measure the hot and cold holdinci of potentially hazardous <br /> foods during ail times of be oth coeratron: [(Yes❑ No <br /> 9_ 1 am providing the folowing hot temperature control for the hot hobd,ng of all potentially hazardous foods a:rove <br /> 135°F <br /> (3 Camp stove Q Sterno &hotel trays <br /> ❑ Double steamer ❑Steam�zanle&lids <br /> ❑ Electric stoti+e top ❑CXher Ispecify: <br /> Note: Exanipiles of potentially hazardous food include: meats, tamales. cooked beans. rice. <br /> vegetables`potato salad,eggs,and dairy products. <br /> 1868 E. liazelton Avenue I Stocktom California 952051 T 209 468-3420 1 F 209 464-0138 1 www.sigov.org)'ehd <br /> EMQ W02 Pao 7 ul 11 TEW EVENT APP <br /> 062>7 Xl133 <br />