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R EC-008 SAN JOAQUIN Environmental Health Department COUNTY— Grew r— c,-. , - � TEMPORARY FOOD VENDOR'S APPLICATION Ali food vendors (both for profit and non-profit) are required to return a signed and completed copy of this checklist to the festival coordinator three (3) weeks prior to this event. Music in the Park 7/25/2026 1. 1.Name of Event: Date(s): 2. The following is information about my organization/business: Name of organization/business: Heart of Lima Bakery 17473 Oberlin Ave Address: 5109848374 Phone: Alternate: Alfajores and Empanadas; Peruvian/Reg Soda &Water 3, List food to be sold or given to the public: 4. 1 am providing food that is NOT prepared at home: [;�Yes ❑ No All food is prepared on-site or is from approved commercial facilities: F�Yes ❑ No Name of facility: Stockton Community Kitchen Phone: Address of facility:110 N El Dorado St Stockton, CA 95202 5. 1 am providing a booth with the following: (to protect my unpackaged food and food-preparation areas from flies. dust and the public) A booth with walls and ceiling constructed of either wood, canvas, plastic, similar material and line mesh fly screening, completely enclosing open food areas. It will also have a smooth and cleanable floor (concrete, asphalt, clean Tarps and smooth wood are acceptable) and constructed to separate food and food preparation areas from the public. ❑ Other(specify): Note: The only operations not required to provide enclosed booths are those which sell beverages from approved dispensers, or prepackaged foods from approved sources. 6. Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods: Approved bottled waler. ❑ On-site hose bib that is connected to a potable water source. ❑ Other(specify): 7. Electricity is provided for my booth's use: �Yes ❑ No 8. 1 am providing an accurate probe thermometer to measure the hot and cold holding of potentially hazardous foods during all times of booth operation: [�Yes ❑ No 9. 1 am providing the following hot temperature control for the hot holding of all potentially hazardous foods above t35"F: ❑ Camp stove [ Sterno & hotel trays ❑ Double steamer ❑ Steam [able & lids ❑ Electric stove top Other(specify) Note: Examples of potentially hazardous food include: meats, tamales, cooked Paeans, rice, vegetables, potato salad,eggs, and dairy products. 1868 E. Hazefton Avenue I Stockton, Calilornia 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org'ehd EHD 16-02 Page 7 of 11 TEMP EVENT APP OG'13'19 i7