Laserfiche WebLink
SKJOAMIN, Environmental Health Department <br /> 1 , ws <br /> TEMPORARY FOOD VENDORPS APPLICATION <br /> All food vati&rs(both for profit and non-profit)are required to return Ei signed and completed copy of ftg checklist to <br /> the f0sWall coordinator three(3�weeks prior to this evont, <br /> I 1.NameofEvent:_Purnpkin Fair 10/01 - 10/02/22 <br /> 2. The following is infomi2tion about my organization1bust mss: <br /> Name of orgarilzationt,busine-s8: Starz Cupcakes <br /> Address: 3743 Dakota Avenue, Riverbank, CA 95367 <br /> Phone: (831 ) -119-9919 Alteniate: (831 ) 332-9243 <br /> 3, List food to W Wd or g1van to the public,,.,-Cupcakes, Water, Soda <br /> 4. 1 am providing food that is N.0T prepared ;at home: N Yes El No <br /> AN food is prepared on-elite or Is from approved cornmerdal facilklm L]Yes L]No <br /> Name of fadlity, Lulu's Kitchen Phone-,(916) 447-9023 <br /> Address of facility: 701-16th Street,, #130, Sacramento, CA 95814 <br /> 5. 1 am providing a booti with the following,(to protect my Lmpaakaged food and food-prapara.tiop areas from files, <br /> dust and the pubk) <br /> DA booth wilh w0s and coiling oonsVucted oifeither wood, canvas,plastic, similar maWa;arid fine mesh fly <br /> screening, complately endosing open food areas, 1041 also have a <br /> asphalt,dean tarps and SmGth wood are acceptable) and Constructed I N�Fea <br /> areas from the publo. <br /> F1 0111her(spKIfy): <br /> Note; The ody operations not required to provide eaclosed b ot� <br /> approwd dispensers,or prepaokaged foods from approved,sourcE7' <br /> 6, Approved water for drinking,utensil and hand washing will be provided In <br /> E]Approved bojt;ad water, <br /> ❑0"Ile hose bib(hat is conn6cliod to a.potable water sourca, <br /> El Others Refrigeration unit with prepackaged cupcakes <br /> 7, ElodrIcity Is provided for my booth's use:K]Yes E]No <br /> B. I am providing an acourate probe (hermometer to measurs the hot w14 cold holding of potentially hazardous <br /> foods during all times of booth operation-IK Yes El No <br /> 5. 1 am providing the ibliavoing hot temperature control for the hot holding of ad potentially hazardous foods above <br /> 135*F, <br /> El camp Steve ❑Sterna&Hotel trays <br /> U o0uhle steamer L]Steam table�lids <br /> Ej F10000 Move top Ej Other(_Ved(y) <br /> Note., Examptos of potentially hazardous food Include: meats, tamales, cooked beans, rice, <br /> vegetables, potato salad,eggs,and dairy products. <br />