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` RFC-©08 <br /> AN : VA�� I1� rilr.rs�•�;~ir mental E-`emith Depavirnent <br /> C*LINTY <br /> "il li il'.`ti4.. Clefl(li(!SS fff-P 4'r,} ll C'7 f', <br /> TEMPORARY FOOD VENDOR'S APPLICATION <br /> All lood vendors (both for profit and non-profit) are required to return a signed and completed copy of this checklist to <br /> the feslival coordinator three(3) weeks prior to this event. <br /> Music In the Par,.. <br /> 1. t.Name of Evenl: �...Date,',;): _ P_ow <br /> 2, The following is information about my organ!zatiombusiness: <br /> Name of organization/business: Shish Grill - _..... <br /> Address: 1061 Market Place San Raman CA ' <br /> i <br /> Phone: +1 (925)-415-3270 Alternate: I <br /> I <br /> 3. List food to be sold or given to the public: Chicken Shawarma wrap, Falafel, Gyro, Fries, & Lamb Burger <br /> i <br /> I <br /> 4. 1 am providing food that is NOT prepared at home: es o <br /> All food is prepared on-slie or is from approved commercial facilities:7651]1\10 <br /> Name of facility: Shish Grill Phone: <br /> Address of Iaci Illy. C <br /> 5. f am providing a booth with the following: (to protect my unpackaged food and food-preparation areas from files, <br /> dust and the public) <br /> �✓ booth with walls and ceiling constructed of either wood, canvas, plastic, similar material and f ine mesh fly <br /> 'Mening, 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 /> Diner(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 bythe following methods: <br /> 2Approved battled water. <br /> 11)n-site hose bib that is connected to a potable water source. <br /> 7. Pther(specily): <br /> ectricily is provided for my booth's use Ye ✓No <br /> 8. 1 am providing an accurate probe the a r asure the hot and cold holding of potentially hazardous <br /> foods during all limes of booth operation Ye o <br /> 9. 1 am providing the following hot temperatu e ontro o the hot holding of all potentially hazardous foods above <br /> amp stove ✓ Sterno& hotel trays <br /> Ilouble steamer Steam table & lids <br /> leotric stove top Other(specify) <br /> dote: Examples of potentially hazardous food include: meats, tamales, cooked beans, rice, <br /> vegetables,potato salad,eggs,and dairy products. <br /> 1868 E. l-lazelton Avenue 1 Stockton,California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/ehd <br /> ENO 16-G2 Pag©7 of 11 TEMP EVENT MP <br /> 08/19119 <br /> �f <br />