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■» <br />1. <br />2. <br />Address: <br />Phone: <br />3. <br />4. <br />5. <br /> Other (specify): <br />6. <br />dfbn-site hose bib that is connected to a potable water source. <br />9. <br />meats, tamales, cooked beans, rice, <br />TEMP EVENT APR <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 />(P^pproved bottled water. <br /> Stemo & hotel trays <br />0 Steam table & lids <br /> Other (specify) <br />Environmental Health DepartmentSAN 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 />EHD 16-02 Pa9e 7 of 11 TEMP EVE.MT A! <br />07/01/2025 <br />Date(s). y/3''^)/2^^ <br /> Other (specify): _________________________________________—-----------— <br />Electricity is provided for my booth’s use: LPYes □No <br />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: fc/jYes No <br />I am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br />>35°F: <br /> Camp stove <br /> Double steamer <br /> Electric stove top <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: RD-DlFtK/ A/0^ <br />The following is information about my organization/business: <br />Name of organization/business: tAhJ GSkJ D/J7 £7' IaNFT <br />7/355 KJi USlfia __________ <br /> Alternate: ( <br />List food to be sold or given to the public: <br />I am providing food that is NOT prepared at home: 0Yes No <br />All food is prepared on-site or Is from approved commercial facilities: 0 Yes No <br />Name of facility: -5^x^04^*4714 kfiTtd Phone; (2^?) <br />Address of facilityS (AaAA.- <br />I am providing a booth with the follov^ng: (to protect my uripackaged food and food-preparation areas from flies, <br />dust and the public) <br />[HA 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.