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Environmental Health Department <br />2. <br />Phone: <br />3. <br />4. <br />5. <br />6. <br />9. <br />7. <br />8. <br />SAN JOAQUIN <br />------COUNTY------- <br />ehD6?J2 HaZelt°n AvenUe 1 Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />06/19/19 Page 7 of 11 TEMP EVENT APR <br />Date(s): <br />meats, tamales, cooked beans, rice, <br />TEMPORARY FOOD VENDOR’S APPLICATION <br />,o re,um a sisned and compie,ed ropy °f to <br />1- 1. Name of Event: <br />The following is information about my organization/business: <br />Name of organization/business: g>MoKey Joe.c, <br />Address: ^37- wy <br /> Alternate: ( )__________________ <br /> List food to be sold or given to the public: t <br />I am providing food that is NOT prepared at home: Yes No <br />All food is prepared on-site or is from approved commercial facilities: Yes &No <br />Name of facility: ---------------------------------------------------- -----------------phone; ( )______________ <br />Address of facility: <br />' ^sTand the publte)1 P'0’6* unpackaSed food food-preparation areas from flies, <br />B^ninT^tSlV^iCeilin9 constrfuctad of either w°°d' “nvas. plastic, similar material and fine mesh fly <br />9|’ C°™pletely endosing open food areas. It will also have a smooth and cleanable floor (concrete <br />Xs fromthe p^bNc3 aCCeptable) and constr^ted to separate food and food preparation <br /> Other (specify): <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 />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 provided for my booth’s use: [^LYes No --------------------------------- <br />' pro.vlding a" accurate probe thermometer to measure the hot and cold holding of potentially hazardous <br />foods during all times of booth operation: O Yes O No y <br />' « pr°V'ding ,he foil°w"S hot temperature control for the hot holding of all potentially hazardous foods above <br />® Camp stove [J Sterno & hotel trays <br /> Double steamer steam table & lids <br /> Electric stove top 0 other (specify) <br />Note: Examples of potentially hazardous food include: <br />vegetables, potato salad, eggs, and dairy products.