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SAN JOAQUIN Environmental Health Department <br />TEMPORARY FOOD VENDOR’S APPLICATION <br />i <br />2 <br />3 <br />4 <br /> OJwCspoae/) <br />6 A«ro.-c<; for Ov*nj UonU ird MrC » to prcv«5od r rrr/ txx<."> by To 'c-’o.r.; "'oCxxh <br />boOM water <br />9 <br />meet*. cotAed been*, rice. <br />ttv* tVt*T *Zf <br />are re^xed to « ugred arto ocr*p^ed copy & r>» cToO Hl to <br />7 <br />8 <br />Note: The orty operatcm net reQMred to provtoe wxtowJ booths are nose w*xn soi be«wraQM *x«- <br />apprevoo sponsor* or prepaoeped ‘oods from souroos <br /> Ssomo 4 hotel rey* <br /> Ssaem tatto & i<3s <br /> OTer(»pec<y) <br />'esUNo <br />y to rrwesure the hot rto ooM hotonp o< pctootaty riuaroxn <br />free No <br />rVJtlkd <br />OjogoUx^ <br />Ma booth W<h waH end cc-'n; ooreexitJed of ether wood canves piasbc s«-=kx '-atcrul and 'ne mosh fry <br />KTOonng. corrpieeafy onctosniQ open tood areas R w4 also ha»e a smooth and ocarutw froor iconaete <br />asphart. ctoen Urps and smooth wood are »xec<ab< and oonstnjaed to secoraie tood and food preparaten <br />aroaa from the potec <br />A’l food vendors (both for preft and ncn.pr^» . <br />T» festrr^ ooordnMor three (3) prer to rsa <br />1 N^-e of I vent LOtX GRAPE F ESThtAl <br />Nou: Eaampfae of poUnbaily Iwardous food Include: <br />vegetable*, potato salad, eg^s. and dairy products. <br />hose t>e nat <s ccnnoaod to a pouue water scare <br /> Orer (speafy)_________________ <br />Eiectnot/ a provded tor my booth * use V <br />I am prondng an acoxate probe therr»S <br />foods dxoj aiunes of t»x*h eperaren <br />I am prordng re toflo*nng hot tampertoA oertret lor the hot hotorg of »a poeente^ neearoxja tooo* above <br />13ST <br /> Camp stove <br /> Ooube steamer <br /> Etoctnc store top <br />Tba totowng • r/ormalon about r-y crgarvatcr.tusross <br />Name of orgareatontousnass _______________________ <br /> J 20 A> vA 7^61CA o <br />(7&> ___ Afterrme ( )____ <br />Let toed to be *c*d or gven to the pxec rfe^V> <br />I am pres-dng Sxd that o NOT trepared at hy-a bs>c» No <br />AS Sxd «s prepared on see or a from approved oom-erpai faoMes j£/»s No <br />Name of facet/ ________________________________________Phone (_____) <br />AWess of faofcfy__________________________________________________________________________ <br />I am piwdng a booth wth th* toacemg (to pxrect my <xto*>-»?od tood and food creceraecn areas from <%** <br />dust and ne putoc) <br />Qjtey,) Sf»1?.1$»24 <br />1868 E Mazeeon Avenue | Stockton, C^t<»' a $6?;i5 | T 2W -pys _u201 f 2<® <br />Oto 1*07 <br />vo/yy