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Environmental Health Department <br />WV Date(s): SW^ V-K <br />1. <br />2. <br />) <br />3 <br />4. <br />5 <br />which sell beverages from <br />Noto <br />6 <br />9 <br />I >£L C •<?/' <br />7 <br />8 <br />SAN JOAQUIN <br />( OUNTY- <br />meats, tam.bs. cooked beans, rice, <br />— 209 468-3420 | <br />Paye 7 of I' <br />F 209 464-0138 I ««« sjgov o,g/ehd^ <br />1868 E Hazelton Avenue I <br />EHD If- 02 <br />07/01/2024 <br />asphalt, clean tarps <br />areas 1----- <br /> Other (specify): — <br />t c nnt reauired to provide enclosed booths are those <br />: The only operations no . d foods from approved sources. <br />^Approved bottled water. <br /> Other (specify). - <br />Bectridty is provided for <br />I am providing an < <br />.Xro^ingtnefollowmg..- <br />135°F: | <br /> Camp stove <br /> Double steamer <br /> Electric stove top <br />Note: Examples of potentially <br />vegetables, pot— <br />1 —«-»——“ <br /> Sterno & hotel trays <br />Q Steam table & lids <br />0 Other (specify) iaXxI <br />- ••, hazardous food include: <br />i— nnrf dairy products.,tato salad, eggs, and dairy p <br />Alternate: ( <br />Stockton. California 95205 | T <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.Name of Event 11 <br />The following is information about my organization/business. <br />Name of organization/business p 12^0——S-LC <br /> <br />Address: ------ <br />Phone: ( I ------ <br /> List food to be sold or given to the public: <br />I am providing food that .sNOJ prepared at home: JZfves □ No <br />All food is prepared on-site or is from approved commercial facilities: ^Ves No <br />Name of facility: . sq.u ______ <br />Xro^dingaL-S^X <br />dust and the public) <br />□•A booh walls ...cw.SW.ot.."°°X''^Taia .XtW Ito* (swK.to. <br />from the public.