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Environmental Health Department <br />Datefs):/^ - <br />2. <br />2 <br />Alternate: () <br />3. <br />4. <br />5. <br />6. <br />9. <br />meats, tamales, cooked beans, rice, <br />7. <br />8. <br />SAN JOAQUIN <br />COUNTY------ <br />the festival coordinator three (3) weeks prior to this event. <br />1. <br />™?6!2Ha2eltonA',enuel Stockton. California 95205 | T-209 468-3420 | F 209464-0138 | www.sjgov.org/ahd <br />06/19/19 06 TEMP EVENT APP <br /> Other (specify): <br />Sa SSS.X5X2 ““ •“ - <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 /> Other (specify): <br />Electricity is providedtor my booth’s use: d Yes No------------ ------------------------------------------------------------ <br />the ho'and cow hoi<i'n9 a po,en,iai* h“s <br />1 the followin9 hot temperature control for the hot holding of all potentially hazardous foods above <br /> Camp stove q sterno & hote| trays <br /> Double steamer steam table & lids <br /> Electric stove top Q other (specify) <br />Note: Examples of potentially hazardous food include: <br />vegetables, potato salad, eggs, and dairy products. <br />/I f <br />TEMPORARY FOOD VENDOR’S APPLICATION <br />non-Profit) are required to return a signed and completed copy of this checklist to <br />~IV uno UVUIIl. <br />1. Name of Event: <br />The following is information about my organization/business: <br />Name of organization/business: <br />Address: 7.5 V/ x < 9 <br />Phone: <br />List food to be sold or given to the public: <br />I am providing food that is NOT prepared at home: E'Yes No <br />All food is prepared on-siteqr is from approved commercial facilities: Yes No <br />Name of facility: Phone-( ) <br />Address of facility: 727/ 3 ‘7// <br />1 and S puHfc}1 'he fOll°Win8: <to Pr°‘eC'my and food-preparation areas from flies, <br />rat les <br />1