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9/24/25, 5:28 PM processed-C96C7FFD-C1A7-4D29-9F46-F7D218CD6960.jpeg <br />Environmental Health Department <br />2 <br />Addreas <br />Phone <br />3 <br />Si4 <br />5 <br />those which sell beverages from <br />6 <br />6 <br />9 <br />meats, tamalos. cooked bean*,neo, <br />1/1 <br />i <br />SAN JOAQUIN <br />COUN v <br />ts provided for my booths use^YMHNo » proving an a^ra-.e rxohr P U N° <br />'866 t Mazehon A»r -ue ( Srocktcr <br />t-C, ts-CX <br />G7’>' <br />https://mail.google.com/mail/u/3/#search/rdsoc%40outlook.com/FMfcgzQcpwlwWrqCthQXdRbqLrDMBhpk?projector=1&messagePartld=0.1 <br />CaMnm*|, 85205 |T 2t>9 468-3420 | F 2C-9 464 0138 | www^gow org^ehd <br />**’ c< nvp’vev w <br />A. tad TEMP0RARY FOOD VENDOR'S APPLICATION <br />1 ______.... i <br /> -DeUhS. <br />’ o, Ew,t K___________ <br />oik"' 'X) II InfomiMon ab«d my Ixuamzinxvbu^n,,, <br /> <br />CQIOU <br />_________ <br />^<n0atobOWao,Irvw,fctfieAhrjtXL_Sm4J^h , b.w <br />AJU^T™1"9 '°°a V1"’ a 182 preparfa 81 ho"'« 0Y« □ NO <br />Mm. ’ 'ror’<WOrawd <«nnWro8l f.oM« Q No <br />Addross of faalrtv ~ ---------- Phone {--------} <br /> "no (h“ L'tfc”' ”* 'Oto'"ns to CTO'8c! <br />SZF0*'“b'”' P'“'K ,nd m«'’ "» <br /> Other (speafyj <br />NO,°' XS oX’nT ™' re9Ur00. 10 pro"de enclosed booths are <br />peneere. es> pmpaGKamjd fuuds from apfiroveU sourr*ts <br />water fi. (jnnki, ,R u!einSlJ and hard ^shJng Wilj provide£j my m&Tv)(ls <br />£. Approved bodlea water <br /> On-sde hose txb that« connected to a <br /> Other (specify). <br />7' Prov’dea fDr NO------------------------------------------------------------------------------— <br />foodTthe h01 and mid hoto’Hfl of potentially hazardous <br />“^ST VW’ng fdflaMn9 hot temperature control for the hot hokUng of all potentaity hazardous foods above <br />B Camp stove Siemo & hotol trays <br />i-j Ooubie steamer Q tabJe & |Kfe <br /> Etectrc stove top Other (specify) <br />Noto E„mplo. of potentially hazardous food include <br />vegetables potato salad eggs, and dairy products.