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SAN J UA Q U i N Environmental Health Department COUNTY TEMPORARY FOOD VENDOR'S APPLICATION All 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. 1. 1-Name of Event: LODI STREET FAIRE Rate(s): MAY 3, 2026 2. The following is information about my organization/business: Name of organizationlbusiness: MAMA'S TOUCH SPECIALTY COOKIES Address: 21600 N KENNEFICK RD ACAMPO 95220 Phone.- ( 209-)a27--0548 __ _ __. Alternate, ( ) 3. List food to be sold or given to the public: DECORATED SUGAR COOKIES 4. 1 am providing food that is NOT prepared at home: ❑Yes }W No All food Is prepared on-site or is from approved commercial facilities: ❑Yes KI No Name of facility: Phone: Address of facility: 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 fine 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, utensll and hand washing will be provided in my booth by the following methods: ❑Approved bottled water. ❑ On-site hose No that is connected to a potable water source. ❑ Other(specify): _ 7. Electricity is provided for my booth's use: ❑Yes lA No 8. I 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 136°F: ❑ Camp stove ❑ Sterno&hotel trays ❑Double steamer n Steam table & lids ❑ Electric stove top L] Other(specify) Note: Examples of potentially hazardous food include: meats, tamales, cooked beans, rice, vegetables, potato salad,eggs, and dairy products, j 1868. E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3426 F 209 464-0138 1 www.sjgov.orglehd EH6 18412 Page 7 of 91 TEMP EVENT APP 07/0112025