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R EC-008 <br /> S A N J O A Q U I N Environmental Health Department <br /> -COUNTY <br /> lam;"f' 1! <br /> TEMPORARY FOOD VENDOR'S APPLICATION <br /> All food vendors (both for profit and non-profit) are requ}red to return a signed and completed copy of this checklist to <br /> the festival coordinator three (3) weeks prior to this event. <br /> Juneteenth Colehration June 20, 2026 <br /> 1. 1.Name of Event: faate(s): <br /> 2. The following is information about my organization/business: <br /> Heart of Lima Bakery <br /> Name of organization/business: <br /> 17473 Oberlin Ave Lathrop, Ca. 95330 <br /> Address: <br /> (510) 984-8374 <br /> Phone: Alternate: <br /> Alfajores& Em pan adas(Prepackaged)',Peruvian/Regular Soda,Water <br /> 3. List food to be sold or given to the public: <br /> 4. 1 am providing food that is NOT prepared at home: U Yes ❑ No <br /> All food is prepared on-site or is from approved commercial facilities: U Yes ❑ No <br /> Name of facility: Stockton Community Kitchen Phone: <br /> Address of facility:110 N El Dorado St Stockton, CA 95202 <br /> 5. 1 am providing a booth with the following: (to protect my unpackaged food and food-preparation areas from flies, <br /> dust and the public) <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 constructed to separate food and food preparation <br /> areas from the public. <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 /> 6. 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 /> 7. Electricity is provided for my booth's use: U Yes ❑ No <br /> 8. I am providing an accurate probe thermometer to measure the hot and cold holding of potentially hazardous <br /> foods during all times of booth operation: [;�Yes ❑ No <br /> 9. 1 am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br /> 135OF: <br /> ❑Camp stove ❑ Sterno& hotel trays <br /> ❑ Double steamer ❑ Steam table & lids <br /> ❑ Electric stove top ❑ Other(specify) <br /> Note: Examples of potentially hazardous food include: meats, tamales, cooked beans, rice, <br /> vegetables, potato salad,eggs,and dairy products. <br /> 1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-3120 1 F 209 464-0138 1 www.sjgov.orglehd <br /> EHD 16-02 Page 7 o1 11 TEMP EVENT APP <br /> 06.'19.19 <br /> 1 <br />