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Environmental Health Department 2. ca •Address: Alternate: () Phone: 3'List food to be sold or given to the public: nS 5: Other (specify): On-site hose bib that Is connected to a potable water source. meats, tamales, cooked beans, rice, 6 4. I e' 1 Note: The only operations not required to provide enclosed booths are those which sell beverages from approved dispensers, or prepackaged foods from approved sources. ^3 Sterno & hotel trays S. Steam table & lids Other (specify) 0I 9: Date(s): ^/io > > 01111 Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods: [^Approved bottled water. Note: Examples of potentially hazardous food include: vegetables, potato salad, eggs, and dairy products. 4@feSANsJOA0UIN -------COUNTY------ Greatness grows here. TEMPORARY FOOD VENDOR’S APPLICATION 1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 [ www.sjgov.org/ehd EHD 16-02 Page 7 of 11 TEMP EVENT APP 07/01/2025 Other (specify):______________________________________________________ Electricity is provided for my booth’s use: 0 Yes No 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 I am providing the following hot temperature control for the hot holding of all potentially hazardous foods above 135°F: , Camp stove Double steamer Electric stove top I am providing food that is NOT prepared at home: £] Yes No All food is prepared on-site or is from approved commercial facilities: K] Yes No Name of facility:Phone: ( ) Address of facility: I am providing a booth with the following: (to protect my unpackaged food and food-preparation areas from flies, dust and the public) 1 ^4 A booth with walls and ceiling constructed of either wood, canvas, plastic, similar materia! and fine mesh fly screening, completely enclosing open food areas. It will also have a smooth and cleanable floor (concrete, 1 asphalt, clean tarps and smooth wood are acceptable) and constructed to separate food and food preparation areas from the public. i I 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: The following is information about my organization/bustness: Name of organization/business: _