Laserfiche WebLink
R EC-008 _ <br /> SAKOAQUIN Environments! Health Department <br /> —COUNTY— <br /> Greatr,ess grows here. <br /> TEMPORARY FOOD VENDOR'S APPLICATION <br /> All loud vendors(both for profit and norvvit) are required io return a signed and completed copy of thls checkist V <br /> the festival coordinator three(3)weeks prior to this event. <br /> Far^ <br /> 1. 1.Name of Event: IYam_ -C�Y1� <br /> 2. The lollowing Is rnformavon about my organlzatfoNbusiness: <br /> Name of organ izatiorvbuslness; L �z <br /> 3��wEss <br /> Phone: 2 1 Altemate: <br /> 3 List lood to be soSd or given to the public: <br /> 4. f an providing food ih ' NOT prepared a1 h—A.5-Do <br /> All food Is prepar sit is trcm approved commercial 1acilitl;51Qi <br /> Name of laciildy: P tons. <br /> Address of facility: <br /> S. 1 am providing a booth with the following:(To protect my urpackaged food and loud-preparation areas from flies, <br /> dust and the public) <br /> booth with walls and ceiling constructed of either wood,canvas,plastic,similar material and tine mesh fly <br /> ing, completely enclosing open food areas. 11 will also have a smooth and cleanable floor(concrete, <br /> asphalt dean tarps and smooth wood are acceptable)and constructed to separate food and food prepar-Minn <br /> areas from the public. <br /> 11:11her(specify): <br /> Note: The only operations not required to provide endosed booths are Those which salt beverages from <br /> approved dispensers,or prepackaged loods from approved sources. <br /> 6. Approved water for drinking,utensil and hand washing will be provided in my booth by the following methods: <br /> Z4pproved bottled water. <br /> Dn•shc hose bib that is connected to a potable water source. <br /> her(specify): $t,�' r' <br /> 7. icity is provided for my booth's use e o ' 1 ort�b C - cam �� t a <br /> 8. 1 am providing an accurate probe the au re the hot and cold holding of potentially hazardous z <br /> roods during all times of booth operation e o 1 <br /> 9. I am providing the following hot temperate f7tr the hot holding of aft potentially hazardous foods above <br /> amp siove emo&hotel trays <br /> oude steamer earn table&lids <br /> lectric stove! 3L,,^ b��c °'`� 6'^-rKAex �av-c <br /> top her{specify) ar c1 �rt11 , cSn�FF a1,5v zl ss 000� <br /> ��SU1 cti�r <br /> Note: Examples of poteMlally hazardous food include: meals, tamaies, cooked beans, rloe, <br /> vegetables,potato salad,eggs,and dalry products. <br /> 1868 E.Hazelton Avenue I Stocklon,California Wi I T 209 468.3420 1 F 209 464-0138 1 www.slgov.orglehd <br /> Eli 1 bog Page 7 ar 1 t <br /> 116i79'14 cf TRAP EVENT App <br />