Laserfiche WebLink
Environmental Health Department <br />TEMPORARY FOOD VENDOR’S APPLICATION <br />Date(s): 1. <br />2.The following is information about my organization/business: <br />Name of organization/business: <br />CAM 11/ T14 frt-A ST4!\Address: <br />Phone:(-^ 10 ) <br />3.List food to be sold or given to the public: <br />4. <br />5. <br /> Other (specify): <br />Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods.6. <br />9. <br />meats, tamales, cooked beans, rice. <br />7. <br />8 <br />Approved bottled water. <br /> On-site hose bib that is connected to a potable water source. <br />Note: The only operations not required to provide enclosed booths are those which sell beverages from <br />approved dispensers, or prepackaged foods from approved sources. <br /> Sterno & hotel trays <br /> Steam table & lids <br />Fl Other (specify) <br />1868 1; Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www sjgov.org/ehd <br />EHD 10-02 Pafle 7 of 11 TEMP EVE NT APR <br />07/01/2024 <br />SAN JOAQUIN <br />COUNTY <br /> A booth with walls and ceiling constructed of either wood, canvas, plastic, similar material and fine mesh fly <br />'screening, completely enclosing open food areas. It will also have a smooth and cleanable floor (concrete, <br />asphalt, clean tarps and smooth wood are acceptable) and constnicted to separate food and food preparation <br />areas from the public. <br />Note: Examples of potentially hazardous food include: <br />vegetables, potato salad, eggs, and dairy products. <br />All food vendors (both for profit and non-profit) are required to return a signed and completed copy of this checklist to <br />the festival coordinator three (3) weeks prior to this event <br />foods during all times of booth operation: Yes No <br />I am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br />135T: <br />0 Camp stove <br /> Double steamer <br /> Electric stove top <br />ZY1 irvU. AT Ari A Mwi <>F <br /> Alternate: ( ) <br />I am providing food that is NOT prepared at home: 0 Yes No <br />All food is prepared on-site or is from approved commercial facilities: 0 Yes No <br />Name of facility: Un. I CA .TpC-t HU CQADfEhone: ( Z(X|) - TT| (U <br />Address of facility: j~~] Tri S h vhith Cl ■ •$TTCU-Trij/I C/\ CH TOCz----------------------------------- <br />I am providing a booth with the following: (to protect my unpackaged food and food-preparation areas from flies, <br />dust and the public) <br />'WoO -rvUX-cY. <br />1 .Name of Event: 0Avi;F THi> plTR-f) <br /> Other (specify):________TririOV1 s a H ff-tQ <br />Electricity is provided for my booth’s use: Yes No <br />I am providing an accurate probe thermometer to measure the hot and cold holding of potentially hazaidous