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^1^ <br />Environmental Health Department <br />1. <br />2. <br />Address: <br />Phone: <br />3. <br />4. <br />5. <br /> Other (specify): <br />6. <br />9. <br />meats, tamales, cooked beans, rice, <br />TEMP EVENT APP <br />7. <br />8. <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 />^fon-site hose bib that is connected to a potable water source. <br />SAN JOAQUIN <br />------COUNTY------- <br />Greatness grows here. <br />TEMPORARY FOOD VENDOR’S APPLICATION <br />Note: Examples of potentially hazardous food include: <br />vegetables, potato salad, eggs, and dairy products. <br />1868 E. Hazelton Avenue I Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />1 ~ rrun rx/ckiT aiEHD 16-02 Pa9e 7 of 11 • ——................. <br />07/01/2025 <br />All food vendors (both for profit and non-profit) are required to return a signed and completed copy of this checklist to <br />the festival coordinator three (3) weeks prior to this event. <br />1. Name of Event: Date(s): <br /> Other (specify): ___ ________________________—— <br />Electricity is provided for my booth’s use: Q^Yes O No <br />I am providing an accurate probe thermometef to measure the hot and cold holding of potentially hazardous <br />foods during all times of booth operation: pVes No <br />I am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br />r-J35°F: rm <br />[Z Camp stove [Q^temo & hotel trays <br />[Q45ouble steamer Steam table & lids <br /> Electric stove top Other (specify) <br />The following is information about my organization/business: <br />Name of organization/business: Mf) flMJ GSE/ kJ PZ/'Z 4 /'FFT <br />//335 lAD/.Cfl <752C/d_____________ <br />2^55___ Alternate: (^6^) <br />List food to be sold or givejp^tiie,public: z J} <br />I am proving food that is NOT prepared at home: \Z Yes □ No <br />All food is prepared on-site or is from approyed/Commercial facilities: ^Yes No <br />Name of facility: /IJ)CJQUas/Ei , Phone: 77/ <br />Address of facility: ^^7/ZS <br />I am providing a booth with the fqltowingf^io protect my unpackaged food and food-preparation areas from flies, <br />dust and the public) <br />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.