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SAN JOAQUIN <br /> <br />1:-'invironrrionad athWTartrnent <br />COUNTY <br />Greatness groy.s here <br />TEMPORARY FOOD VENDOR'S APPLICATION <br />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 />Feast at the Fox Sepetmeber 6, 2024 <br />1. Name of Event: Date(s): <br />The following is information about my organization/business: <br />Name of organization/business: Kitchen @StoneBrier <br />Address: 4780 West Lane, Stockton, CA 95210 <br />Phone: ( 209 ) 951- 4391 Alternate: ( 209 ) 951- 4391 <br />3. List food to be sold or given to the public: UMW' 196a-1 producu <br />I am providing food that is NOT prepared at home: g. Yes r] No <br />All food is prepared on-site or is from approved commercial facilities: IA Yes El No <br />Name of facility: Tylf, minui Phone: ( //0q ) 32-- 2- <br />Address of facility: '11 n INtit 1411,1. <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 />KI 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 />fl Other (specify): <br />Note: The only operations not required to provide enclosed booths are those <br />approved dispensers, or prepackaged foods from approved sources. <br />Approved water for drinking, utensil and hand washing will be provided in my booth <br />Vi Approved bottled water. <br />LII On-site hose bib that is connected to a potable water source. <br />Other (specify): <br />Note: Examples of potentially hazardous food include: meats, <br />vegetables, potato salad, eggs, and dairy products. <br />tamales, cooked beans, rice, <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sjgov.org/ehd <br />END 16-02 Page 7 of 11 TEMP EVENT APP <br />06/29/2023 <br />which sell beverages from <br />by the following methods: <br />Electricity is provided for my booth's use: Yes D 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: M Yes O No <br />I am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br />135°F: <br />LI Camp stove EfSterno & hotel trays <br />Lii Double steamer 1] Steam table & lids <br />IA Electric stove top El Other (specify) Warming Box