May 11, 2019 St. Lucy School and Church 2350 S. Winchester Blvd, Campbell, California Chili Cooks Application Packet Rules & Regulations, Signature of Waiver with Chili Cook Application, Department of Health Application and Regulations
RULES & REGULATIONS: For Traditional Red Chili and Homestyle Chili There are generally two types of chili and two separate judging categories. You may choose between the International Chili Society (ICS) sanctioned chili for Traditional Red or non-sanctioned Homestyle, judged as people s choice for which the general public chooses their favorites. ICS Traditional Red contestants must also compete in the Homestyle contest. Traditional Red Chili is any kind of meat or combination of meats cooked with red chili peppers, various spices and other ingredients. Beans, pasta and corn are not allowed. This is a part of the International Chili Society (ICS) sanctioned event and all are welcome to participate. All Traditional Red Chili cooks must register for this cookoff through the ICS website at www.chilicooks.com. ICS will immediately send us the registered cook s name, email, phone number, and ICS member number. Winning this event will allow you to compete in Regional, State and the World Championship Chili Cookoff. Homestyle Chili, judged by the community as People s Choice is any kind of meat or combination of meats and/or vegetables cooked with beans, chili peppers, various spices and other ingredients. Beans are required. This application must be signed by the person in charge and posted on the wall of your booth acknowledging that you understand the rules and regulations of this event. Anyone found in violation of these rules will be asked to leave and be disqualified from all contests. Every contestant must complete an Application for a Temporary Food Facility (TFF) Permit at a Temporary Event that is required by the Health Department. There is an $88 fee required with this permit application. Please complete the attached form and provide a check payable to Department of Environmental Health. Return the form and check with this application no later than April 26th. No ingredient may be pre-cooked in any way prior to the commencement of the official cookoff. The only exceptions are canned or bottled tomatoes, tomato sauce, peppers, pepper sauce, beverages, broth and grinding and/or mixing of spices. Meat may be treated, pre-cut or ground. MEAT MAY NOT BE PRE-COOKED, in any manner. All other ingredients must be chopped or prepared during the preparation period.
A representative of Campbell San Jose West Rotary Club shall conduct a contestant s meeting, at which time final instructions are to be given and questions answered, no later than 1 hour prior to the official starting time of the cookoff. Each contestant must cook a minimum of two gallons of Homestyle Chili prepared in one pot which will be chosen by the public as a part of our People s Choice judging. Sharing or splitting chili with another contestant for the purpose of increasing the number of entries in any event is strictly forbidden. Chili may only be served only in the 2 oz plastic cup tasting cups with the 1½ oz ladle that will be provided to you. Any serving cup must be previously unused in any manner. Homestyle Chili is governed by Campbell San Jose West Rotary Club. Non-compliance by a contestant of the chairman s requirement will result in disqualification. You must be an ACTIVE ICS member to compete in any ICS competition including Traditional Red Chili. Each ICS contestant will be assigned a contestant s number by the Chief Scorekeeper and given an official 32 oz. ICS judging cup. In order for a cook to receive the judging cup for their specific contest, they must sign the contestant list and provide their active ICS membership number. Each contestant should verify that the number on the bottom of their cup is the same as their assigned contestant number. Each contestant is responsible to deliver their cup, which must be filled to the bottom of the cup s rim, to the judging area at the official time for judging: 11:00 am. No outside alcohol is permitted onsite. No music please. We ll have entertainment. However, we encourage bellringing, clapping, hooting and hollering to encourage the community to taste and vote for your chili. We also encourage you to decorate your booth for the Most Spirited Booth Contest. Vehicles must be parked in vendor parking (not by booth with the exception of loading and unloading).
Chili Cooks Supply List Supplied by event: 10 x 10 food service booth with windows (style/color varies) One table for cooking/serving Small metal cooking table Serving ladle Instant thermometer Wash station for equipment and hands (no running water) Bleach Serving gloves You will need to bring: Chairs Additional table for preparation area (highly suggested) Cooking stove - THERE WILL BE NO ELECTRICITY AVAILABLE Cutting boards (keep meat cutting board separate from vegetable and other food items) 3-4 gallon or larger cooking pot (no enamel-coated or galvanized equipment is allowed) All other cooking equipment Ice chest (separate ice chests for warm and cold foods; meats should be separate from vegetables and other items) Ice Ingredients for chili Bottled water for your team Vessel for tasters to put voting beans in (a decorated cup/jar/bucket etc.) Receipts for perishable ingredients purchased within 48 hours prior to the event Solid waste can and garbage bags Liquid waste container (bucket) Container for grease (if applicable) Dishwashing and hand soap Clean dish towels for wiping and cleaning Fire extinguisher Recommended items: Pot holders/towels/paper towels, tape and table covers Snacks and drinks for your team Banner and decorations for your booth
Chili Cook Application Form (Due no later than April 26, 2019) Chili Competitor s Team Name Contact Person Phone Email Addres Please check the area(s) in which you would like to compete. 1st Place 2 nd Place 3 rd Place ICS - Red Chili Contest $500 $250 $100 PC - Homestyle Chili Contest Prizes/Gifts Gifts Gifts Most Spirited Booth Gift All contestants are required to prepare a minimum of 2 gallons (or more) of Homestyle Chili. ENTRY FEES: Traditional Red (ICS sanctioned and People s Choice) contestants $35 if prepare 2 gal of Homestyle chili $ $0 if prepare 4 gal of Homestyle chili $ 0 Contact name hereby agrees to all the rules and regulations and hold harmless the Rotary Club of Campbell and West San Jose (including its Officers, Directors, Members, Volunteers, District and Parent organizations) for all costs and expenses, including reasonable attorney fees incurred as a result of any legal action, in law or equity, brought against them as a result of our participation in the Chili Cookoff held on May 11, 2019. We further waive all rights of recovery against the Rotary Club of Campbell and West San Jose for loss or damage as a result of our participation. Cook s Signature Date
1. Mail completed/signed Chili Cook Application Form with your entry check (if applicable) made out to Campbell/West San Jose Rotary Foundation 2. Include your Application for a Temporary Food Facility (TFF) Permit at a Temporary Event with an $88 check payable to Department of Environmental Health. 3. Return the forms and check(s) with this application to: Yvonne Kendall or Karen Russell 250 E. Hamilton Avenue, Suite B Campbell, CA 95008 For more Information: 408 371-8181 or yvonne@yvonnekendall.com Thank you so much for your participation and support of our fundraiser supporting local youth!
County of Santa Clara Department of Environmental Health 1555 Berger Drive, Suite 300, San Jose, CA 95112-2716 Phone 408-918-3400 Fax 408-258-5891 www.ehinfo.org Application for a Temporary Food Facility (TFF) Permit at a Temporary Event 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 www.ehinfo.org > Programs & Services > Consumer Protection Division > Temporary Events. BUSINESS INFORMATION Business or Organization Name / DBA Owner Name or Care Of 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 E-mail Address Event Coordinator Name and Phone TEMPORARY FOOD FACILITY (TFF) INFORMATION Facility Type: Food Booth If your food booth will be larger than 10 x10, indicate size: 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 Multiple food service stations: submit a simple site plan depicting where food and beverages (including beer/wine) will be distributed. Date(s) Date(s) Date(s) Date(s) Time(s) Time(s) Time(s) Time(s) PERMIT TYPES (must check one, as applies) TE06 - RC1 Low-risk food TE07 - RC2 Moderate-risk food, prepared for same-day service (1-12 days) TE08 - RC2 Moderate-risk food, prepared for same-day service (13+ days) TE09 - RC3 High-risk food, prepared in advance, cooked, cooled, and/or reheated (1-12 days) TE10 - RC3 High-risk food, prepared in advance, cooked, cooled, and/or reheated (13+ days) TE14 - NO FOOD/BEVERAGE SALES SAMPLING ONLY TE01 - 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 honorable discharge form without your social security information) Food Preparation Start Time: (Before Time) BOOTH CONSTRUCTION INFORMATION Name of Temporary Food Facility: (Booth name to show on permit) Overhead Covering: Canvas Wood Other: Person in Charge Day of Event: Floor: Asphalt Concrete Wood Tarp Other: (Grass or Dirt surfaces must be covered with approved tarps or plywood) Person in Charge s Cell Phone: Walls: Screens Canvas Wood Other: (Enclosed food booth required if unpackaged foods are handled) 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. I have read and understand the Requirements for Temporary Food Facilities in the County of Santa Clara and hereby agree to adhere to them. The undersigned certifies, under penalty of perjury, that to the best of his/her knowledge and belief, the statements made herein are complete, correct and true. NOTE: Any information contained in this application is a matter of public record and is available to the public under the California Public Records Act. Applicant Signature Print Name Date ***** OFFICE USE ONLY ***** OW#: FA#: PR#: BO#: PFR (Processed Food Registration) CFO Certified Producers Certificate Other Rev 12/15
ATTACH ADDITIONAL SHEETS IF NECESSARY. County of Santa Clara Department of Environmental Health 1555 Berger Drive, Suite 300, San Jose, CA 95112-2716 Phone 408-918-3400 Fax 408-258-5891 www.ehinfo.org FOOD INFORMATION: A complete listing of ALL food/beverage products served, sold, sampled, or given away from your facility must be detailed below. Business Name: Menu Item(s) Include all food, beverages, condiments and all extra ingredients served with each item. (1) Prepared in Advance Prepared ONLY at event Item will be served AT the Event: (2) Pre-packaged Hot Cold Room Temperature Cook to Order Temporary Event Name: (3) Serve samples Preparation Methods AT the Event: List food equipment to be used at the event (e.g., cold-holding and hot-holding devices, rapid reheating methods, cooking equipment, sneeze guard protection) AND any additional preparation methods. - If any potentially hazardous foods will be held at room temperature, you must submit a written procedure for approval. Example: Hamburger X X X X BBQ to cook, chafing dish to hot-hold Example: Cookies X X Food storage containers Thaw Cut / assemble / portion Cook / bake / grill BBQ / Deep fry Reheat (1) ADVANCE PREPARATION activities at approved kitchen No advance preparation 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 this facility for the or Commissary Name specified date(s) and time(s). If this permission is rescinded, I will immediately Address and City notify County of Santa Clara, Department of Environmental Health (408-918-3400). Phone # Date(s)/Time(s) of Pre-Event use Valid Health Permit in Santa Clara County (SCC). Enter facility #: FA Facility is permitted outside SCC (ATTACH A COPY OF VALID HEALTH PERMIT). (a) Describe food items and how they will be prepared. Print name of Permit Holder or Authorized Kitchen Representative Signature Date (b) Describe cooling procedure for potentially hazardous foods (PHF). (Include how temperatures will be monitored and verified.) No PHFs (2) Will you PRE-PACKAGE food/beverages before the event? No Yes - submit a copy of your valid Processed Food Registration. If you pre-package any foods or beverages, a Processed Food Registration is required. Visit the state s website for more info: www.cdph.ca.gov. (3) SAMPLING Procedures: Samples prepared in advance? Yes No Samples pre-portioned and pre-packaged in advance? Yes No Include how and where samples will be prepared and how they will be served. TEMPORARY EVENT APPLICATION REVISED 12/15