Laserfiche WebLink
I <br />2. <br />Phone: <br />4. <br />5. <br />6. <br />8. <br />9. <br />Ao I' Joc>cU <br />meats, tamales, cooked beans, rice, <br />SAN JOAQUIN <br />----COUNTY----- <br />the festival coordinator thre^fS) weeks prior to this <br />1. <br />ehd ?6-02 HaZe,ton Avenue 1 Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />06/29/2023 Pa9e 7 of 11 TEMP EVENT APP <br />TEMPORARY FOOD VENDOR’S APPLICATION <br />~ • «« •» -» « « » <br />Event Ytrolr. nV m,,,, | <br />The following is information about my organization/business: <br />Name of organization/business: <br />Address: 3P34__CelebraVbn Dri'^ <br />< ZM ) 6^ <br />List food to bo sold or gr/sn to the public: <br />__ ___________________ __________ <br />C4~ ^52.^ 2_ <br />Alternate: (2.0^ ) $ 0^ ~ GOQ^ <br />Jrlrtlcs- Ica, L'Crrtontde,, <br />I am providing food that is NOT prepared at home: i^Yes No <br />All food is prepared on-srte or is from approved commercial facilities: Yes No <br />Name of facility: (^nVcUpay Phone (7/k| ) 6^2-4^ 5 <br />Address of fae9i-y:_3O3U_____VriY z / nH'i f .4- <1524 2- <br />^st'and the puMic^ (t0 protect my tmpacka'ged food and foo5?reparation’areas from flies. ‘ <br /> A booth with walls and celling constructed of either wood, canvas, plastic, similar material and fine mesh flv <br />s"®e™n9; con;Plete|y enclosing open food areas. It will also have a smooth and cleanable floor (concrete <br />aX fromTe pubfcn Sm°°th WOOd are acceptable) and “"^cted to separate food and food preparation <br /> <br />pother (specify):| y InU <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 /> Approved bottled water. <br /> On-site hose bib that is connected to a potable water source. <br />Giner (specify;: QQaCfj- xj UAion <br /> 'Electricity is provided for my booth’s use: Q Yes No r ------------- <br />’ ^nvaCCUr?K pr<?e thermomrg}er to measure the hot and cold holding of potentially hazardous <br />foods during all times of booth operation: JS^Ves No <br />I am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br />i *30 r". <br />I I Camp stove | | Sfemo & hotel travs <br /> Double steamer steam table & lids <br /> Electric stove top pother (specify) fjQ <br />Note: Examples of potentially hazardous food include: <br />vegetables, potato salad, eggs, and dairy products.