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SAN JOAQUIN <br />TEMPORARY FOOD VENDOR’S APPLICATION <br />1 1 Name of Event Datefsi <br />2 <br />Address <br />Phone Ii Alternate: () <br />3 List food to be sold or given to the public <br />4 <br />5 <br />Self contained Food trailerOther (specify) <br />6 <br />9 <br />r ta/etton Avenue <br />7 <br />B <br />Note Examples of potentially hazardous food include <br />vegetables, potato salad, eggs, and dairy products. <br />F .'Oh 4fi4 di IM | www S|gov o<g.'*?hd <br />>1 I:VI N» APf- <br />Yos No <br />hone| <br />■.tocklon. Ottiforriia 95206 f 209 468 M2''i <br />r of r r <br /><5©^ <br />Environmental Health Department <br />June 7-8, <br />2025 <br />Approved waler for drinking, utensil and hand washing will be provided <br />. J Approved bottled water <br />) On-site hose bib ttiat is connected to a potable water source <br />Self contained Food trailer <br />use No <br />186« f <br />11in •<. <br />in my booth by the following methods <br />' > c t’ r 1 <br />Ail food vendors (both for profit and non-profit) are roqu.red to return a signed and completed copy of this checklist to <br />the festival coordinator three (31 weeks prior to this event <br />Watermelon stroot-fair_____ <br />The following is information about my orgamzation/business: <br />Name of orgamzabon/busmess: . CrepeTea <br />P.O. Box 692012 stockton ca 95269 <br />I am providing food that is NOT prepared at home. Q Yos'S(^No'\ <br />All food is prepared on-site or is from approved commercial facilitiosJ^' <br />Name o< tac.hty .California food truck wasFk. phone(209i) 464-9707 <br />dust and the public) <br />meats, tamales, cooked beans, rice. <br />Note The only operations not required to provide enclosed txiotfis are those which soil beverages from <br />approved dispensers or prepackaged foods from approved sources <br />Other (speedy) <br />Eloctrxity is provided for my booth s uso.gO Yes Ci No <br />i am providing an accurate probe thorrndflioter io measure the hot and cold holding of potentially hazardous <br />foods during all times of booth operation O No <br />I am providing the following hot lemperaturcMoritrol for the hot holding of all potentially hazardous foods above <br />135"'r <br /> Camp stove Q Slerno & hotel irays <br />j Double steamer [~l Steam table & lids <br /> Elect)rc stove lop [,J Other (specify) <br />i A booth with walls and ceiling constructed ol either wood, canvas plastic, similar material and fme mesh fly <br />screenmg. completely enclosing open food areas II will also have a smooth and cleanable floor (concrete <br />areas fro^the' "bl’ a 'd S’T,OO,h W00<J afe acceP,ab,e) anri constructed to separate food and food preparation