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All food vendors (both for profit and non-profit) are required to return a signed and completed copy of this checklist to <br />the festival coordinator three (3) weeks prior to this event. <br />1. Name of Event: St. Luke Catholic Church Parish Festival Date(s): 9/7/24-9/8/24 <br /> <br />The following is information about my organization/business: <br />Name of organization/business: St. Luke Catholic Church <br />Address: 3847 N. Sutter St., Stockton, CA 95204 <br /> <br />Phone: ( 209 ) 986-0353 <br /> <br />Alternate: ( 209 ) 948-3450 <br /> <br />Lumpia, fresh fruit, cotton candy, frosties, hamburgers, <br />List food to be sold or given to the public: various Vietnamese dishes, BBQ, various Mexican dishes <br />shaved ice, boba drinks, rangoon <br />I am providing food that is NOT prepared at home: D Yes fl No <br />All food is prepared on-site or is from approved commercial facilities: 0 Yes 0 No <br />Name of facility: Phone: ( <br />Address of facility: <br />I am providing a booth with the following: (to protect my unpackaged food and food-preparation areas from flies, <br />dust and the public) <br />0 A booth with walls 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. <br />Other (specify): <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 />Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods: <br />D Approved bottled water. <br />0 On-site hose bib that is connected to a potable water source. <br />D Other (specify): <br />Electricity is provided for my booth's use: D 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: El Yes 1:1 No <br />I am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br />135°F: <br />Camp stove D Sterno & hotel trays <br />LI Double steamer LI Steam table & lids <br />Electric stove top D Other (specify) <br />Note: Examples of potentially hazardous food include: meats, tamales, cooked beans, rice, <br />vegetables, potato salad, eggs, and dairy products. <br />1868 E. Hazelton Avenue I Stockton, California 95205 T 209 468-3420 I F 209 464-0138 I www.sjgov.org/ehd <br />EHD 16-02 Page 7 of 11 TEMP EVENT APP <br />07/01/2024 <br />SAN JOAQUIN <br /> <br />Environmental Health Department <br />COUNTY — <br />Greatness grows flare <br />TEMPORARY FOOD VENDOR'S APPLICATION