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<br />5.png <br />,31 AM2! <br />Environmental Health Department <br />r <br />TEMPORARY FOOD VENDOR’S APPLICATION <br />Date(s)1. <br />2 <br />3. <br />4. <br />i <br />5 <br />I <br />6 <br /> 'rLnFBgDTTSCJnkzlg?projector=i&me8MBepart|d_() 1 <br />Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods <br />Approved bottled water. <br />0 On-site hose bib that is connected to a potable water source. <br />7. <br />8. <br />9. <br />sjgov.org/ehd <br />TEMP EVENT APP <br />135T: <br />-.□Qamp'tt ov® <br /> DoMe steamer <br />O Electric ftow top <br />!OMUW <br />COUNTV - <br />[C] Other (specify):_____________________________________________ <br />Electricity is provided for my booth's use:® Yes □No <br />I am providing an accurate probe thermometer to measure the hot and cold holding of potentially hazardous <br />foods during all times of booth operation.jX’) Yes O No <br />I am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br />Stemo & hotel trays Steam table & lids <br /> Other (specify) <br />PwMTiriifWR nf wily hazardous food include: meats, tamales, cooked beans, rice. <br />eggs, and dairy products. <br />Ml food vendors (both fot profit and non profit) are required to return a srgned and completed copy of this checklist to <br />the festival coordinator three (3) weeks prior to this event. <br />1 Name of Even. ' (J ia <br />The following is information about my organization/business. <br />Name of organization/business Tcwos Tau)^ <br />Address: <br />Phone. ( 2U*} ) b G> 6 I 5 3______________ Alternate; (}jJC\) M I *>2- <br />List food to be sold or given to the public: C1.U) b; <Ti | <br />\ (\ca. <br />I am providing food that is NOT prepared at home.g5.Yes No <br />All food is prepared on-site oris from approved commercial facilities^) Yes O No <br />Name of facility: U/ncVl Phone: (2^ <br />Address of facility. \<| {'"}• <5 2-OG- <br />' am providing a booth with the following: (to protect my unpackaged food and food-preparation areas from flies, <br />dust and the public) <br /> A booth with wails and ceiling constructed of either wood, canvas, plastic, similar material and fine mesh fly <br />screening, 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. , j I ■ \ <br />£) O^er (specify): TWC^/ ^yVWuL {jCc/C I <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 />E. Marftltno Avemie I Stockion, California 9520^ 209 468-3420 | F 209 4 64 0138 | www <br />fctO <br />(a/o^fiCQ*