Laserfiche WebLink
image2.png4/17/26, 12:10 PM <br />TEMPORARY FOOD VENDOR’S APPLICATION <br />1 Name of Event C,nco m^0 «vonl1. <br />2 The following is information about my organizatiorvbusiness <br />Reas Aguas frescas y raspados <br />Address: <br />Phone Alternate ()_ <br />Aguas frescas com snow cone3List food to be sold or given to the publ <br />4 <br />209? <br />5 <br />6 Approved water for dunking, utensil and hand washing will be provided in my booth by the following <br />https://mail.google.eom/mail/u/0/#search/gracielacruz81 %40icloud.com/FMfcgzQgKvPx\/FGTjvJKLxzqpQbzvhhS?projector=1 1/1 <br />7 <br />8 <br />9 <br />Name of organization/busmess: <br />6897 cottage st win Ion ca <br /> Stemo & hotel trays Steam table & lids <br />O Other (specify) <br />All food vendors (both for profit and non-profit) are required to return a signed and completed copy of this <br />the festival coordinator three (3) weeks prior to this event <br />Note: Examples of potentially hazardous food include: meats, tamales, cooked beans, rice, <br />vegetables, potato salad, eggs, and dairy products. <br />I am providing food that is NOT prepared at homed Yes No <br />All food is prepared on-site or is from approved commercial facilities Yes O No <br />Name of facility: Lo« Gordo's catering Phone (____). <br />Address of facility:___________________________________________ <br />I am providing a booth with the following (to protect my unpackaged food and food-preparation art <br />dust and the public) <br />Date^ M?y- <br />Cj A booth with walls and ceiling constructed of either wood, canvas, plastic, similar matenal and fir <br />screening, completely enclosing open food areas It will also have a smooth and cleanable floor <br />asphalt, clean tarps and smooth wood are acceptable) and constructed to separate food and foo <br />areas from the public <br />Other (specify): <br />Note: The only operations not required to provide enclosed booths are those which sell beverages I <br />approved dispensers, or prepackaged foods from approved sources <br />Ej Approved bottled water <br />Cjj On-site hose bib that is connected to a potable water source <br /> Other (specify). <br />Electnaty is provided for my booth s use 3 Yes No <br />I am providing an accurate probe thermOTneter to measure the hot and cold holding of potentially <br />foods dunng all times of booth operation! I Yes L I No <br />I am providing the following hot temperature control for the hot holding of all potentially hazardous fc <br />135‘F: <br /> Camp st ove <br />Li Double steamer <br />n Electnc stove top <br />( 209740 ) 5140 <br />1868 E Hazelton Avenue | Stockton, California 95205 I j 209 468-3420 1 F 209 464-0138 | www sjgo' <br />EHD 16-02 Page 7 0» 11 7 <br />07101/2024