20 15 Food Vendor Application Beautiful Downtown Campbell October, 17 & 18, 2015

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1 20 15 Food Vendor Application Beautiful Downtown Campbell October, 17 & 18, 2015 Rules & Regulations, Signature of Waiver, Food Vendor, Menu & Calculation of Fees, Department of Health (DEH) Information *Please read carefully, as changes have been made to this application due to City of Campbell, County Fire and Department of Health Department regulations* This event is located in beautiful, historic downtown Campbell, California. Attendance estimates are about 50,000 visitors over the weekend. This is a fun entertaining family festival with fine arts & crafts, business vendors, commercial vendors, food vendors, Gordon Biersch Beers, wine and continuous live entertainment. Event Sponsor For more information please contact the Campbell Chamber of Commerce Tel: Fax: info@campbellchamber.net Mail applications to: 267 E. Campbell Avenue, Suite C, Campbell, California 95008

2 2015 CAMPBELL OKTOBERFEST FESTIVAL INFORMATION Oktoberfest features food booths, local wine and Gordon Biersch Brewing Company fine beers. Along with live entertainment, fine arts & crafts, local business vendors and our kids zone. Oktoberfest will be held October 17, & in downtown Campbell. Festival hours are from 10am - 6pm and 10am - 5pm on Sunday. This is an outdoor festival and will be held rain or shine, no refunds! 2015 CAMPBELL OKTOBERFEST FOOD VENDOR APPLICATION **All Food Vendors must have and provide a copy of a current Certificate of Insurance the Campbell Chamber of Commerce/Oktoberfest must be named as additionally Insured for no less than $1,000,000. (One Million dollars). Vendor understands that security, accident, theft and product liability insurance related to their booth and merchandise is solely their responsibility Please fill out all the attached necessary paper work, and applications for the Health Department and Fire Department. Any applications returned incomplete will not be accepted. NEW FEES FOR HEALTH PERMIT. The Dept of Health (DEH) has a new fee schedule which can be confusing. New fees are based on a Risk Category 1, 2 or 3. There are no longer non-profit discounts for food vendors. Please read the fee schedule included in this packet carefully to determine your risk category. DEH has the right to change your fee based on their calculations and has final say. All food vendors will be provided a 10x10 health & fire approved booth. Any vendor cooking with an open flame must have a flame-retardant booth and a fire extinguisher with a minimum rating of 2A10B:C. Food vendors of flambé or deep fat frying, are required to have a fire extinguisher rated for class K fires. All fees to be paid to the Campbell Chamber of Commerce who will write one organizational check to the Santa Clara County Health Department. A $200 Security Deposit is required in a separate check which will be voided or returned after the festival if, ALL Festival, City and DEH rules and regulations were met. If Rules & Regulations were not met by the representatives, the deposit check will be cashed by the Campbell Chamber of Commerce. FENCING - Application fees DO NOT include fencing for adjacent cooking area. All Food Vendors must supply their own brown or white fencing to isolate the cooking area from the public. The area to be fenced is approximately 100sq.ft. A minimum of four 10 foot sections is acceptable. If the Campbell Chamber needs to supply the fencing, the Food Vendor will be responsible for payment of $75.00 per 10 foot section. Notice must be given to the Chamber as soon as possible. FLOORING - All food vendors must provide complete coverage for flooring. Booth Floor must be completely covered with either 3/8 plywood and OR flame retardant tarp Fire regulations require 4ft. between food booths and an open flame. If you have an open flame your space will be 24 feet including a 10ft. x 10ft. booth space and a 4ft. x 10ft. cooking area. Vendor must remain on site until closing, both days. No alcohol is allowed in booth Completed application must include a picture or handwritten drawing of booth set-up. Selling of water, soda, beer or wine is not allowed. Non carbonated drinks, such as juice will be permitted. The Committee will consider all applications received. The Committee's decision is based on the needs of the Oktoberfest festival. Vendors will be notified of their acceptance and approved menus in a timely manner. Those accepted will receive space assignment and set-up information by the last week of September. All placement decisions are final including those who paid additional fee for placement request. NO NEGOTIATIONS! Priority on menu items and pre-packaged items is given to returning vendors. Fill out all health permit forms completely and return with application and appropriate fee. If the organization is Veteran Exempt, please fill out the necessary information included on the Temporary Event Permit from DEH. In favor of the environment, the use of paper, aluminum and other recyclable food containers is required for our vendors. 2

3 2015 CAMPBELL OKTOBERFEST FOOD VENDOR APPLICATION GENERAL I NFORMATION: The Campbell Chamber of Commerce reserves the right to locate vendor booths according to the needs of the festival. Any vendor cooking with an open flame must have a flame-retardant booth and current fire extinguisher minimum rating 2A10B:C or class K for flambé or deep fryers. All display and selling area must be placed within your 10 x 10 space. No booth sharing is allowed Electrical service is not provided. Generators are not allowed. You are responsible for refrigeration of beverages and food items Overnight security will be provided. However, each vendor is responsible for securing their own booth. The Campbell Chamber of Commerce/Oktoberfest is not responsible for any loss or theft incurred by any vendor. No Refunds for cancellations after September 17. If you are not accepted as a vendor, all fees will be returned. Please make arrangements to provide your own table and chairs. Tables should be covered with a washable surface. Vendors are responsible for removing their own trash from their area each evening and may not use trash receptacles used by public for its disposal. Each food booth must provide its own large garbage cans behind booth, nothing against walls or other vendors. Clean up of your booth area is be done by you the vendor. Should the area require special cleanup, the vendor will be responsible for the additional cost. Food Vendor understands that it is their responsibility to leave their booth, sidewalk and surrounding area clean and in order, both days. The vendor agrees not to pour or allow, grease, cooking oil or other like substances on the ground. Anyone pouring grease, cooking oil or cleaning fluids in the drains, will be fined up to $25, plus the cost of cleanup. ABSORBENT SOCK/Shop-Vac system Is required during clean up to capture any fluids. Absolutely NO FLUID run-off is permitted to go down the City drainage system. A fine of $25, or more could be levied on offending vendor. All fines noted are imposed by the respective governing agency. Fines will be processed by the Health Department, County Fire, or any other government agency, all fines will come from that agency and be payable to them. Your $200 security deposit will be shredded or returned to you after the festival if you follow all general rules and your space is left clean. Pending city inspection. The Campbell Chamber of Commerce/Oktoberfest has the right to prohibit and/or evict (without refund or assumption of liability for lost sales or expenses) any presentation or person who is in any manner deemed offensive or unprofessional. All vendors agree to participate for the entire event and understand that tear down on Sunday before 5:00pm is not allowed for any reason.. Load-in for the event will be between 6:00am-8:00am Saturday October 17. Please drop your equipment and merchandise off at your booth space and proceed directly to parking and registration. All vendors must register by 9:00am. If you are not checked in by 9:00am, you will be considered a no-show, without a refund. We reserve the right to add a booth or have adjoining booths absorb your space. Your space must be completely set up by 9:30am and open for business by 10am. All vehicles must be moved from the event area immediately after unloading. No Exceptions! If your vehicle is left unattended during set-up, you will be towed. Saving our environment, the use of paper, aluminum and other recyclable food containers is required for our vendors. The Santa County Department of Health will be onsite to enforce all requirements in the morning and throughout the day. 3

4 2015 CAMPBELL OKTOBERFEST FOOD VENDOR APPLICATION FIRE DEPARTMENT: If vendor is cooking with electricity or flame, vendor must have a FIRE EXTINGUISHER (Dry Chemical, 2AIOBC or Class K with a current tag). FIRE DEPARTMENT WILL BE ON SITE FOR INSPECTIONS OF ALL BOOTHS. Have all workers trained in use of the extinguisher. SALES PERMIT: A valid sales permit can be obtained from the State Board of Equalization office in San Jose. Phone (408) for information or an appointment. The vendor is responsible for collecting and paying all sales tax to the State Board of Equalization and for obtaining the sales permit prior to the event. HEALTH PERMIT: Copy the informational pages and train all workers on these regulations. Inspectors will be on site both festival days to insure compliance. All Health Department regulations will be enforced even after the inspectors have left the grounds. No menu changes will be allowed without written approval. Food may not be sold or sampled outside of the booth. Campbell Chamber of Commerce/Oktoberfest does not take responsibility for any vendor who is shut down for non-compliance. Absolutely no refunds will be granted if a food vendor is shut down by the Health Department or festival management for non-compliance. 4

5 2015 CAMPBELL OKTOBERFEST FOOD VENDOR APPLICATION Please keep a copy for your records BUSINESS NAME: Contact Name: Address: City/State Zip Tel: Fax Cell: Type of food: Explain in detail the food you wish to serve. Please try to make your menu items match the theme of the festival if possible. The Campbell Chamber of Commerce reserves the right to limit the variety of foods served. Food vendors may only sell non-alcoholic, fruit juice drinks. THE FOLLOWING MUST BE SUBMITTED AT TIME OF APPLICATION: Failure to submit required information will delay this process. At least 1 picture of your booth display (layout will determine best location for your space) Signed Acceptance of Waiver Health Department Application, (TFF) filled out and returned Calculation of Fees. (please use separate check for security deposit which will be returned to you after the event, if you follow guidelines and leave your area clean) ENTRY FEES: Food Booth Vendor Price $2, $ Priority Booth Placement if available (first come, first serve) $ Separate Check $ Cleaning Deposit Check (will be returned after event) $ Separate Check $ Health Department Permit (See page for fee) $ Late Filing Fee - Application received after September 18, 2015 $ $ Silver Elite Campbell Chamber Member ($1,000.00) $ Bronze Campbell Chamber Member ($500.00) $ Total amount enclosed $ I understand that booth placement and vendor approval is prioritized by the Chamber event committee A non-refundable fee of $ may be submitted for priority placement. This will be on a first come, first serve basis, as corners are limited. Vendor must be a fully paid up member in good standing of the Campbell Chamber of Commerce Application, signed agreement and fees, must be received by September 11, 2015 Please make all payments, payable to the Campbell Chamber of Commerce 267 E. Campbell Avenue, Suite C, Campbell, CA / 5

6 DEPARTMENT OF ENVIRONMENTAL HEALTH FEE DESCRIPTION Temporary Food Facility RC 1 includes C$99l: Prepackaged, non-potentially hazardous foods (non-phfs), or Prepares only non-phfs. Examples include prepackaged foods/beverages, kettle corn, candies. Reheating commercially manufactured ready to eat foods with no further processing. Examples include canned chili beans, hot dogs, nacho cheese Temporary Food Facility RC 2 includes C$145l: Food that is for same day service to customers (hamburgers, raw sausages, crepes etc.). Food that is prepared/cooked onsite and served with hot or cold holding of potentially hazardous food (PHF) after preparation. Absolutely no cooling of potentially hazardous foods are allowed, either in advance or on site. All prepared food is to be discarded at end of day (includes hot foods, and any cold foods that have exceeded 41F). The business owner of a brick and mortar food facility with a valid permit, prepares in advance of the event (potato salad, pot pies, and tamales) at their approved facility; the facility must have a valid permit and inspected by the local enforcement agency (you are the owner of that fixed facility); must provide a copy of their permit with the application Temporary Food Facility RC3 includes C$186l: Food that is prepared in advance of the event (potato salad, pot pies, and tamales) at an approved facility Extensive menus with the handling and preparation of raw ingredients or complex prepara tion which includes cooking, cooling and/or rehea ting. Food that is prepared in advance of the event (potato salad, pot pies, and tamales) at an approved facility permitted and inspected by the local enforcement agency (you are not the owner of that fixed facility but renting kitchen space, or with the owner's permission) Food that is prepared for multi-day use. All prepared food is to be discarded at end of day (includes hot foods, and any cold foods that have exceeded 41F). PERMIT TYPES FEE 1-12 DAYS FEE 13+ DAYS FOOD VENDOR CATEGORIES PER EVENT PER EVENT Risk Category 1 (RCI) Low Risk $99.00 $99.00 Risk Category 2 (RC2)Moderate Risk $ $ Risk Category 3 (RC3) High Risk $ $ Sampling Only - No Food/Beverage sales $88.00 $88.00 Limited to small sample sizes Mobile Food Facilities - Carts/Vehicles permitted by Santa Clara Co. No temp event fee required operating under annual permit Mobile Food Facilities - Carts/Vehicles NOT under permit by Santa Clara County ATEP-for business owners of fixed food facilities that they own in Santa Clara County Fee will depend on menu - RC1,2,3 $ Annual Fee Veteran *must submit Affidavit for a Veteran's Exemption $0.00 $0.00 form and all required documentation (See form) Form) 6

7 2015 CAMPBELL OKTOBERFEST FOOD VENDOR APPLICATION PLEASE SIGN AND RETURN WITH APPLICATION Please make a copy for your records. Please read the rules and regulations you are signing HOLD HARMLESS: This event is held rain or shine and no space fees or vendor expenses will be refunded should an emergency of any nature arise prior to the opening time or during the event that would prevent or cancel its production. In consideration for being allowed to attend and participate in the Campbell Chamber of Commerce Oktoberfest 2015, vendor agrees to hold harmless the City of Campbell, the Campbell Chamber of Commerce, and their respective elective or appointed boards, officers, agents, and contract employees from any and all claims, liabilities, expenses, or damages of any nature, including reasonable attorney's fees, to the extent such claims, liabilities, expenses, or damages arise out of the participation by Oktoberfest, its agents, officers, employees, subcontractors, or independent contractors, at the festival. In consideration of your acceptance of this entry, I, intending to be legally bound, do hereby for myself and my heirs, executors, and administrators, waive and release any and all rights and claims or damages I may accrue against the persons and organizations affiliated with the Campbell Chamber of Commerce & Oktoberfest for any and all injuries that may be suffered by me at or en route to and from the event. At the conclusion of the festival, all vendors are required to be completely torn down by 8:00pm Sunday, October 18, Anyone who is still on the street after 8:00pm will be invoiced overtime fees of $50 every 15 minutes thereafter. We look forward to seeing you at Campbell 2015 OKTOBERFEST. I have read and understand the terms and conditions as outlined in the Food Vendor Information and Application packet and agree to abide by them. Entrants must sign, signifying acceptance of Hold Harmless waiver Application requirements to participate in the Campbell Chamber of Commerce 2015 Oktoberfest. Contact Name (please print) Company Name: Signature: Date: / /2015 7

8 2015 CAMPBELL OKTOBERFEST FOOD VENDOR A PPLICATION Remember to keep a copy for your records All fees must be submitted with application. Read the terms & conditions carefully and sign the acceptance of waiver, before returning your application. Applications won't be accepted unless full payment, Menu & Fee Calculation form, health permit application, and signed Fire Department Acknowledgement form is returned with food booth application. Company/Organization Name: Contact Name: Address/City/ST/Zip: Phone Cell Fax California Sellers Permit # Contact State Board of Equalization in San Jose for information, application and permit. Your # is required for approval. Public education institutions are exempt. Attach a copy of your current proof of liability insurance naming the Campbell Chamber of Commerce as additional insured for no less than $1,000,000.00(One Million Dollars) VERY IMPORTANT Please fill out the following questions carefully. If you do not disclose something you require, we might not be able to accommodate your request at a later date. FOOD BOOTH All food vendors will be provided a DEH approved 10x10 canopy. Any vendor cooking with an open flame must have a fire extinguisher in their booth. Additional fees will be applied to oversized spaces. COOKING What type of Cooking are you doing on-site (e.g.: BBQ, Deep Frying, none, Etc.) ICE Will you need Ice Delivery? No Yes Ice will be provided in 20lb bags at a cost of $20.00 per bag 8

9 2015 OKTOBERFEST FOOD VENDOR APPLICATION PAYMENT / CREDIT CARD AUTHORIZATION Name as it appears on Credit Card Name Business Name Credit Card Billing Address City State Zip I will be submitting payment by cash or check *Note: If you are submitting payment with a check, there will be a fee of $35.00 on all checks returned from your bank. Please fill out the following and return with your vendor application if you would like to use a credit card to pay for your vendor fees. Visa Mastercard We do not accept American Express Credit Card Number Exp. Code: I authorize the Campbell Chamber of Commerce to charge my credit card for: $ Signature: 9

10 AFFIDAVIT FOR A VETERAN'S EXEMPTION FOOD BUSINESS ENVIRONMENTAL HEALTH PERMIT FEE SANTA CLARA COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH CONSUMER PROTECTION DIVISION 1555 Berger Drive San Jose, CA Tel: This exemption is in accordance with Section 16102, Business and Professions Code, which allows every Soldier, Sailor or Marine of the United States, who has received an honorable discharge or a release from active duty under honorable conditions from such service, to hawk, peddle, and vend any goods, wares or merchandise owned by that honorably discharged veteran, (except spirituous, malt, vinous Q[ other intoxicating liquor), without payment of any license, tax, or fee whatsoever, whether municipal, county or state. This affidavit, together with listed documentation, is to be filed with the Department of Environmental Health in conjunction with the application for an Environmental Health Permit to Operate a food business. BUSINESS NAME: _ BUSINESS LOCATION/ VEHICLE DESCRIPTION:. MAILING ADDRESS: PHONE NUMBER: BUSINESS OWNER (Veteran): OWNER ADDRESS: PHONE: BUSINESS DESCRIPTION: Describe the kinds of food sold and the type of facility they are sold from BUSINESS ARRANGEMENTS WITH OTHERS: Describe the ownership of the products and how paid; franchises, on consignment; commissions; number of employees SOURCE OF FOOD SUPPLIES: (Name and location of suppliers) PROOF OF OWNERSHIP OF BUSINESS: Must be sole proprietorship- not a corporation. (Submit a copy of any two items) Business Lease Business License Board of Equalization VERIFICATION OF OWNERNETERAN IDENTITY: Drivers Lic. # State Class Expiration Date_/_/_ Birth Date _/_/_ Other VETERAN'S SERVICE: USA USN USMC USAF USCG USPHS SERVICE DOCUMENTATION: Attach a copy of Honorable Discharge or other evidence of honorable release from the US Armed Services I understand that I am NOT eligible for consideration for veterans exemption if I engage in the sale of spirituous, malt, vinous or other intoxicating liquor. Initial. _ The foregoing is true of my own knowledge, except as to the matters which are herein stated on my own information and belief, and as to those matters, I believe them to be true. I declare and certify under penalty of perjury, by the law of the state of California, that the foregoing is true and correct. Date: Signature of Honorable Discharged Veteran APPROVED DISSAPROVED SPECIALIST 10 Reason for denial (if applicable) _

11 County of Santa Clara Department of Environmental Health 1555 Berger Drive, Suite 300, San Jose, CA Phone Fax WARM WATER REQUIREMENT FOR HANDWASHING AT CERTIFIED FARMERS MARKETS AND TEMPORARY EVENTS Effective January 1, 2015, DEH will be enforcing the CalCode requirement for warm water (100 F) for handwashing. If a hard plumbed sink with hot and cold potable water is not available, warm potable water may be stored in an insulated food grade container with a spigot that can remain locked in the open position and that is capable of maintaining water warm. There are some containers with a push button spigot that can be retrofitted with lever type spigots. These may be available from the manufacturer or from water container filling stores. All materials must be food grade and must use potable water supply. Options for obtaining warm water for handwashing include, but are not limited to: Heating water at the commissary then filling insulated water containers; Use a hot water heater (such as a coffee maker), then then mix with cold water; Heating water in a clean pot over a range/griddle in the food booth. A handwash station is required to be operational inside the food booth if unpackaged food is handled prior to any food handling, Insulated water container with spigot that locks in open position WARM WATER Liquid soap Catch bucket Paper towels Warm Water Requirement at CFM and TFF, 10/14 1

12 Here is a list of resources you may research further. These are NOT recommendations or endorsements. You must still verify the products are food grade, may store warm water and meet the department requirements. Check with the manufacturer. Igloo s website shows a lever type spigot replacement part. Description states it fits all Igloo 2, 3, 5 & 10 gallon beverage coolers. Search: insulated beverage Search: insulated beverage You may try searching for: lever spigot This is a double walled dispenser. Search: Mainstays 2 Gal Double Wall Dispenser Some filtered water filling stores have a retrofit spigot with lever that may fit some insulated beverage dispensers that have a push button spigot. This document with website hyperlinks may be found on our website: > Consumer Protection Division > Certified Farmers Markets Warm Water Requirement at CFM and TFF, 10/14 2

13 County of Santa Clara Department of Environmental Health 1555 Berger Drive, Suite 300, San Jose, CA Phone Fax APPLICATION TO OPERATE A TEMPORARY FOOD FACILITY (TFF) Complete BOTH sides of this form. RETURN TO THE EVENT COORDINATOR with applicable fees and documentation. Applications, fees must be submitted to this department by the Event Coordinator at least 2 weeks before the event. Incomplete or late applications may not be approved or the menu may be restricted. Once the application is approved, NO changes may be made without approval of this Department. Unauthorized changes may result in permit suspension. For applications and TFF requirements, go to > Consumer Protection Division > Programs & Services > Temporary Events. BUSINESS INFORMATION Business or Organization Name / DBA Owner Name Owner Address City and Zip Code EVENT INFORMATION Event Name Event Location Event Address City and Zip Code Owner Business or Home Phone Owner Cell Phone Address Event Coordinator Name and Phone TEMPORARY FOOD FACILITY (TFF) INFORMATION Facility Type: Food Booth Beverage Booth(s) Total Number of Beverage Booths: Food Cart Food Vehicle (Applies to vehicles not permitted by County of Santa Clara DEH) Truck Trailer Indoor Event Food Preparation Start Time: (Before Time) Name of Temporary Food Facility: (Booth name to show on permit) Date(s) Date(s) Date(s) Date(s) Time(s) Time(s) Time(s) Time(s) PERMIT TYPES (must check one, as applies): RC1 Low-risk foods RC2 Moderate-risk foods, prepared for same-day service (1-12 days) RC2 Moderate-risk foods, prepared for same-day service (13+ days) RC3 High-risk foods, prepared in advance, cooked, cooled, and/or reheated (1-12 days) RC3 High-risk foods, prepared in advance, cooked, cooled, and/or reheated (13+ days) NO FOOD/BEVERAGE SALES SAMPLING ONLY Annual Temporary Event Permit Holder (Santa Clara County) Permit Number (PT#): Veteran (submit the Affidavit for a Veteran s Exemption form with required documentation, along with a copy of your DD214 without your social security information) BOOTH CONSTRUCTION INFORMATION Overhead Covering: Canvas Wood Other: Floor: Asphalt Concrete Wood Tarp Other: (Grass or Dirt surfaces must be covered with approved tarps or plywood) Person in Charge Day of Event: Walls: Screens Canvas Wood Other: (Enclosed food booth required if unpackaged foods are handled) Person in Charge s Cell Phone: Booth Supplier: My own Supplied by Event Rent From: The undersigned hereby applies for a Permit to Operate and agrees to operate in accordance with all applicable state and local regulations, laws, and such inspection procedures necessary to ensure compliance. Additionally, the undersigned is aware that non-compliance may result in closure of the temporary food facility. Any inspection time more than twenty minutes may be assessed, in 15 minute increments, at the current hourly rate approved by the Board of Supervisors, until the necessary changes or corrections are made. Re-inspections may be subject to additional fees. Any unpaid fees will affect approvals to participate in future events. I have read and understand the Requirements for Temporary Food Facilities in the County of Santa Clara and hereby agree to adhere to them. Payment of the required fee to secure a valid permit is required before commencing or continuing operations. Failure to do so may result in a misdemeanor citation, permit suspension/revocation proceeding, and/or closure. Applicant Signature Print Name Date ***** OFFICE USE ONLY ***** OW#: FA#: PR#: BO#: Rev 01.13

14 Event Name: Event Date(s): Booth Name: Menu Item(s) Include food, sampling, beverages, condiments and all extra ingredients served with each item. Food Prepared Prepared in Advance Prepared At Event Item or food sample will be served: Preparation Methods: Storage and Delivery: Pre-packaged Hot Cold Room Temperature Cook to Order Thaw Cut / assemble / portion Cook / bake / grill BBQ / Deep fry Reheat List equipment to be used (e.g., cold-holding and hotholding devices, rapid reheating methods, cooking equipment, sneeze guard protection) AND any additional preparation methods. If any potentially hazardous foods will be held in room temperature, you must submit a written procedure for approval. Indicate food storage location and method when event is not operating (if food will remain in booth, state so) Length of time in transport Example: Hamburger X X X X BBQ, Chafing Dish XYZ Restaurant -refrigerator 15 min. Example: Lasagna X X X X X Ice chest, Oven, Steam Table XYZ Restaurant -refrigerator 15 min. ADVANCE PREPARATION / COMMISSARY AGREEMENT (IF APPLICABLE) Home prepared non-perishable foods may require an annual permit as per Cottage Food legislation. If you do not have a permitted facility, you must obtain permission to use a kitchen or commissary facility which has been approved in advance by the local dept. of environmental health or obtain prepared foods from an approved source. Pre-event food preparation inspections may be required. Have copies of food invoices/receipts at your booth, available for review upon request, as any unapproved foods found will be removed from public distribution. Commercial Kitchen The Applicant submitting this application has permission to use the facility for the specified or Commissary Name date(s) and time(s). If this permission is rescinded, I will immediately notify the County of Santa Address and City Clara, Department of Environmental Health ( ). Phone # Date(s) and Time(s) of Pre-Event Use Name of Permit Holder or Authorized Kitchen Representative Valid Health Permit in Santa Clara County. Enter facility #: FA Signature Date Facility is permitted outside Santa Clara County (ATTACH A COPY OF VALID HEALTH PERMIT). Rev 01.13