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SAN JOAQUIN ! ■ nvirt h!in<Mi:.’’I ! h.'.’ilili 0<'|>;h inici:i TEMPORARY FOOD VENDOR’S APPLICATION i N.-une of event Lodi wine festival .Dalcfs). 4/5/25 2 I he following is information about my organizalion/busincss Name of organization/business Vineyard Crossing micro bakery 3685 massimo cr stockton , caAddress Alternate (Phone (209 ) ■ 623-3933 3.List food to be sold or given to the public: Sourdough loaves, bagels, focaccia, scones, cookies. 4. !> 6 Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods I >| Approved bottled water I ) On-site hose bib that is connected to a potable water source. 9 meats, tamales, cooked beans, rice, | | Sterno & hotel trays ] Steam table & lids I | Other (specify) I other (specify) . | wj|| se|| prepackage baked goods. Note: The only operations not required Io provide enclosed booths are those which sell beverages from approved dispensers, or prepackaged foods from approved sources. 7. H U M” I VI H' API' I | A booth with walls and ceiling constructed of either wood, canvas plastic, similar material and fine mesh fly screening, completely enclosing open food areas. It will also have a smooth and cleanable floor (concrete, asphalt, clean tarps and smooth wood arc acceptable) and constructed to separate food and food preparation areas from the public. I A"'-I'M Note: lixamplos of potentially hazardous food include: vegetables, potato salad, eggs, and dairy products. /\ll food vendors (both for profit and non-profit) are required to return a signed and completed copy of this checklist to Ilic festival coordinator three (3) weeks prior to this event [ Other (specify): | will not cook or prep on site ... .—---------- Electricity is provided for my booth's use I I Yes I No I am providing an accurate probe thermometer to measure the hot and cold holding of potentially hazardous foods during all times of booth operation | x) Yes J | No I am providing the following hot temperature control for the hoi holding of all potentially hazardous foods above 135‘l;: 1 | Camp stove I Double steamer i | ( Jeclric stove top I am providing food that is NOT prepared at home | I Yes ( J No All food is prepared on-sile or is from approved commercial facilities: [ ; Yes [ I No Name of facility. u/a f’hone: ( ) Address of facility: N/a I am providing a booth will) the following (to protect my unpackaged food and food-preparation areas from flies, dust and the public) . I I |,i/(;tuni Avenil.’' .''.tiX'l.lau C.ililoini-im I III) 10 02 I’ixje I cl ■ 1 ()Z'0V?02l