CLARK DEVELOPMENT CORPORATION

Clark Freeport Zone, Pampanga

HEALTH AND SANITATION DIVISION
Tel No. (045) 599-3854 / (045) 599-5417

APPLICATION FORM FOR TEMPORARY SANITARY PERMIT

Date: March 02, 2024

To: CDC HEALTH AND SANITATION DIVISION

SIR/MADAM:

Our company intend to apply for a Temporary Sanitary Permit. Hereunder are pertinent information to support
my application:

Name of Company : Sweet Tooth Angeles

Name of Owner : Mayvelin Soto Tieng

Address: Unit A JMS Building, Mc Arthur Highway Salapungan, Angeles City Tel. No. : 0956 344 8519
Business Activity : Food Concessionaire

Name of Locators / Events: Aurora Music Festival 2024

Item to Sell : Milkshakes, Coffee, and Food

Requirements Presented :

Sanitary Permit valid until ___________________________

Health Certificate valid until _________________________
Water Analysis (Microbiological /Physical/Chemical 10 parameters)
Transfer Permit from respective Municipality (Sanitation Section)

Name of Driver / Deliveryman / Foodhandler’s :

I hereby certify that the above information’s are true and correct. I will cooperate with the inspection of my
premises anytime.

Respectfully yours,

Mayveline Soto Tieng

Signature over printed name