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Environmental Health Department <br />2. <br />Phone: <br />3. <br />4. <br />5. <br />6. <br />9. <br />rice, <br />\ <br />cold holding of potentially hazardous <br />of all potentially hazardous foods above <br />7. <br />8. <br />I www.sjgov.org/ehd <br />TEMP EVENT APP <br />SAN JOAQUIN <br />------COUNTY— <br />use: B Yes No <br />IOmeter to measure the hot and <br />-------••••a u,W1 Mwvui upeidtion: (__| Yes [_| No <br />providing the following hot temperature control for the hot holding <br /> Sterno & hotel trays <br /> Steam table & lids <br />pother (specify) ^ecJ. <br />potentially hazardous food include: meats, tamales, cooked beans, <br />EHDw.o2HaZ6ltonAvenUel Stockton, California 95205 I T 209 468-3420 | F 209 464-0138 <br />06/19/19 Page 7 of 11 <br />TEMPORARY FOOD VENDOR’S APPLICATION <br />the festival coordinatorXee°(3* this t0 3 S'9ned and comPleted C0Py this checklist to <br />1 1Name°fEvent:OAcoUaP Date(5): <br />The following is information about my organization/business- <br />Name of organization/business: \ <br />Address: ^2 ^0 fopon O cA <br /><406 1 ------------ Alternate: ('WA- ) A'g.q - 4 <br />List food to be sold or given to the public: QdCO Cq4W\ <br />I am providing food that is NOT prepared at home. ^Yes □ No <br />Nam^ff °n'Slte °r 'S fr°m approved commercial facilities: ^Yes □ No <br />Address of facility: Phone. £-------)----------------------------------- <br />' Xt anffe foUoW,n9: (t0 protect un^afled food and tooc^preparation arcas from flies. <br />screening, completely Enclosing9 o^e^foSdlreas^? wS^ls^teve and fifte mesh Ay <br />^X^Other (specify):____ <br />,h- ““ - •- <br /> Approved bottled water. <br />^On-site hose bib that is connected to a potable water source. <br /> Other (specify): <br />Electricity is provided for my booth's <br />' ZhT^'09 T aCCUrate pr0be therm^eter to measure the hot <br />foods during all times of booth operation: Yes Nr <br />135°F: <br /> Camp stove <br />O Double steamer <br /> Electric stove top <br />Note: Examples of <br />vegetables, potato salad, eggs, and dairy products.1