Laserfiche WebLink
S A N J OAQ U I N Environmental Health Department <br /> —COUN1TY <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 /> 1. 1.Name of Event: Lodi Street Fair Date(s). 5/4/25 and 10/5/25 <br /> 2. The foAcwing is information about my organizationlbusiness: <br /> Name of organ izationlbusiness: <br /> FREEZYFROSTYLLC <br /> Address: 79 N Menlo Park St Mountain House Ca 95391 <br /> Phone: ( 209.) 321-1817 Alternate: ( ) <br /> 3. List food to be sold or given to the public:Freeze dried candy- freeze dried fruit- Freeze dried vegetables <br /> 4. 1 am providing food that is NOT prepared at home: ❑Yes❑610 <br /> All food is prepared cn-site or is from approved commercial facilities:❑Yes❑No <br /> Name of facility: FREEZYFROSTYLLC Phone: ( 1_209-321-1818 <br /> Address of facility: 79 N Menlo Park St MH CA 95391 <br /> 5. 1 am providing a booth with the following: (to protect my unpackaged food and food-preparation areas from Ries, <br /> dust and the public) <br /> ®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 /> [5t Other(specify): Pre Packaged Food COTTAGE FOOD OPERATIONS <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 /> 6. Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods: <br /> ❑Approved bottled water. <br /> ❑On-site hose bib that is connected to a potable water source. <br /> ❑Other(specify): <br /> 7. Electricity is provided for my booth's use: ❑Yes❑ No <br /> 8. 1 am providing an accurate probe thermometer to measure the hot and cold holding of potentially hazardous <br /> foods during all times of booth operation: ❑Yes❑No <br /> 9. 1 am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br /> 135°F: <br /> ❑Camp stove ❑5temo&hotel trays <br /> ❑Double steamer ❑Steam table&lids <br /> ❑ Electric stove top ❑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 952051 T 209 468-3420 1 f= 209 464-0138 1 www.sjcehd.com <br /> EHD 15-02 Page 7 or 11 TEMP EVENT APP <br /> 0713117 <br />