COMPLIANCE INFO - Laserfiche WebLink

Home Browse Search

SA N J OAQ U I N Environmental Health Department TEMPORARY FOOD VENDOR'S APPLICATION All food vendors (both for profit and non-profit) are required to return a signed and completed copy of this checklist to the festival coordinator three(3)weeks prior to this event. 1 1 Name of Event: Red, White & Brew Wine & Beerfest Date(s) 3/29/2025 2 The following is information about my organizationlbusiness. Name of organ izationlbusiness: Casa Pinoy Address: 15932 Crescnet Park Cir, Lathrop CA 95330 Phone: ( 408)) 7723372 Alternate: ( } 3 List food to be sold or given to the public: BBQ, Lumpia, Noodles, Crispy Pork, Beef salpicao 4 1 am providing food that is NOT prepared at home: ®Yes❑ No All food is prepared on-site or is from approved commercial facilities: ® Yes ❑ No Name of facility Commissary El Gallo Phone: Address of facility 355 N. Guild Ave, Lodi CA 5 1 am providing a booth with the following: (to protect my unpackaged food and food-preparation areas from flies, dust and the public) V A booth with walls and ceiling constructed of either wood, canvas, plastic, similar material and fine mesh fly screening, completely enclosing open food areas It will also have a smooth and cleanable floor (concrete, asphalt, clean tarps and smooth wood are acceptable) and constructed to separate food and food preparation areas from the public. ❑ Other(specify): Note: The only operations not required to provide enclosed booths are those which sell beverages from approved dispensers, or prepackaged foods from approved sources 6 Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods: ®Approved bottled water ❑On-site hose bib that is connected to a potable water source ❑Other(specify) 7 Electricity is provided for my bootF's use ❑ Yes 0 No 5 1 am providing an accurate probe thermometer to measure the hot and cold holding of potentially hazardous foods during all times of booth operation: 2 Yes❑ No 9 1 am providing the following hot temperature control for the hot holding of all potentially hazardous foods above 135°F: ❑Camp stove ❑ 5terno& hotel trays ❑ Double steamer ® Steam table &lids ❑ Electric stove top ❑ Other(specify) Note: Examples of potentially hazardous food include: meats, tamales, cooked beans, rice, vegetables, potato salad, eggs, and dairy products. 1� TLMP PAN, APP Ito 16-02 fl7,Uuznza