Laserfiche WebLink
REC-DO8 <br /> S A NJ A <br /> Environmental Health Department <br /> QU IN <br /> as i-na aj nn <br /> C 0 U 1\1 I �uibmq(l' <br /> TEMPORARY FOOD VENDOR'S APPLICATION <br /> All food vendors (both for profit and non-profit) are required to return a signed and completed copy of this checklist to <br /> the festival coordinator three(3)weeks prior to this event. <br /> 1. 1 Name of Event, Music in the Date(5): 9-91-94 <br /> 2. The following is information about my organ izalion/business,- <br /> Name of organ!zaliombusiness: <br /> Address: <br /> Phone: Alternate: <br /> 3. List food to be sold or given to the public- -PN-73,ft C' + <br /> 4. 1 am providing food that is NOT prepared at home: esl+lo <br /> All food is prepared orile or is from approved commercial facilities-Zes 0 <br /> -21A 2L� <br /> Name of facility: lS- CA Phone: <br /> Address of facility: t cvr CVS <br /> 5. 1 am providing a boot h the 61lowin (to protect myu—npaokaged food and food-preparation areas from flies, <br /> dust and the public) <br /> booth with walls and ceiling constructed of either wood, canvas, plastic, similar material and fine mesh fly <br /> scening, 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 <br /> areas from the public. <br /> ther(specify)" <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 following methods: <br /> []Approved bottled water. <br /> n-site hose bib that is connected to a potable water source. <br /> A, <br /> her(specify): <br /> 7. UIricily is provided for my booth's us Ye No <br /> )r <br /> B. I am providing an accurate probe the asure the hot and cold holding of potentially hazardous <br /> booth <br /> foods during all times of booth operation Ye 0 <br /> ;of a 1( co ro 0 1 <br /> 9. 1 am providing the following hot lemperalu contro the hot holding of all potentially hazardous foods above <br /> q 5OF: <br /> amp stove —Sterno&hotel trays <br /> ouble steamer Seam table&lids <br /> lectric stove top V Other(specify) (D %V vV'-\ <br /> Mole: Examples of potentially hazardous food include: meats, tamales, cooked beans, rice, <br /> vegetables,potato salad,eggs,and dairy products. <br /> 1868 E. Hazellon Avenue I Stockton,California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sigov.org/ehd <br /> EHD 16-02 Page 7 of 11 TEMP EVENT APP <br /> 06119/19 <br />