COMPLIANCE INFO_2020 - Laserfiche WebLink

Home Browse Search

I Environmental Health Department . . 16 n �i A N Q A 111 N ; a } COUNTY— ' Greatness grows here, I 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. j a 1 . 1 . Name of Event: LODI GRAPE FESTIVAL ��j( � r fad rre Date (s) : " � a 2. The following is information about my organization/business: �' �d� �. 4? Name of organization/business: �� i Address : j ; 1 Phone: ( 2657 dj 29 4w )Z Alternate : (Zcq L 3 . List food to be sold or given to the public: �� c�S O*p (� i 4. 1 am providing food that is NOT prepared at home: Yes 0 No All food is prepared on-site oris from-appxovedxoMMereiaFiaei(ities: [A Yes No nv.ld L Phone: (ZeZ > Name of facility: L'fs I. Address of facility: 5 . 1 am providing a booth with the following : (to protect my unpackaged food and food-preparation areas from flies , dust and the public) 0 A booth with walls and ceiling constructed of either wood , canvas, plastic, similar material and fine mesh fly 1 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: i [Approved bottled water. 5On4te hose bib that is connected to a potable water source. . 1 0 Other (specify): 7 . Electricity is provided for my booth's use: Yes ❑ No I 8. 1 re the hof and cold holding of potentially hazardous am providing an accurate probe thermometer to measu foods during all times of booth operation: [6 Yes 0 No i 9 . I am providing the following hot temperature control for the hot holding of all potentially hazardous foods above I 135° F : I El Camp stove ❑ Sterno & hotel trays i ❑ Double steamer 19 Steam table & lids 1 ❑ Electric stove top Gl Other (specify) Note : Examples of potentially hazardous food include : meats , tamales , cooked beans , rice, vegetables , potato salad , eggs, and dairy products . 1868 E . Hazelton Avenue ' Stockton , California 95205 T 209 468-3420 I F 209 484-0138 I WWWSicehd EVENT APP EHD 18-02 Page 7 of 11 TE 07/3/17