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REC-008 <br /> ;•l,,r r113,t1 , <br /> A N ::� A Q Envirn�• mental Health Department <br /> C CCU NTY I <br /> Greatrfass lrnv,.s lir•re, <br /> TEMPORARY FOOD VENDOR'S APPLICATION <br /> All food vendors (bosh for profit and non-profil) are required to return a signed and compleled copy of this checklist to <br /> the festival coordinator three(3) weeks prior to this event. <br /> Musle In Ilia Per,,, Kite Festival Juneteenth July 4 July 20 5/18,6J1,6/15,7/4,7/20 <br /> 1, 1,Name of Event: Date(s) j l <br /> 2. The following Is Information about my organ Izatkonrbusiness: <br /> Name of organizallon/buslness: SI <br /> Address: 1061 Market Place San Ramon CA <br /> Phone: +1 (9251-415-3270 Alternate: <br /> 3, List food to be sold or given to the public: ,Chicken Shawarma wrap, Falafel, Gyro, Fries, & Lamb Burger <br /> I <br /> 4. 1 am providing food that Is NOT prepared at home:21'osD0 j <br /> All food Is prepared on-site or Is from approved commercial facilities: ✓�tu 'es:]No <br /> Name of facility: Shish GO Phone: i <br /> Address of lacllityl.0 1 Market Place Son Ramon CA <br /> 5. I am providing a booth with 1ho lollowing: (to proteet my unpackaged food and food•proparation areas from Illes, <br /> dust and the publlo) j <br /> r <br /> ✓ booih with walls and oeiling constructed of either wood, canvas, plastic, similar material and f Ine mesh fly <br /> ening, 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 1 <br /> areas from the publio, <br /> �J1her(specify): <br /> , <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 /> 6. Approved water for drinking, utensil and hand washing will be provided In my booth by the lollowing methods; <br /> I <br /> ❑✓Approved bottled water. <br /> IlDn•site hose bib that Is corrneoted to a potable water source. <br /> peoldulty <br /> ther(specify): <br /> 7. is provided for my booth's use Ye `/Na <br /> E3, 1 am providing an aecurate probe the r asure the hot and cold holding of potentially hazardous <br /> foods during all times of booth operation `/ Ye o <br /> 0, lam providing tl�e following hot iemporatu ntr tha l7oi holding of all potentially hazardous Inods above <br /> `t5°F: <br /> ramp stave ✓Sferno & hotel trays <br /> 3oublo steamer Stearn table &Ilds <br /> leottlo stove top Other(specify) <br /> Note: Examples of potentially hazardous food Include: meats, tamales, cooked t)eons, rice, � <br /> vegetables,potato salad,eggs,and dairy products. <br /> 1068 E,Hetzellon Avenue I Stockton,Gaktfornka 95205 1 7 209 468.3420 1 F 209 464-0138 I www,sjgov.org/ehd <br /> E-HD I6-02 PnQo 7n1 t 1 MAP EVENTAPP <br /> p6/411!18 <br />