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Environmental Health Department <br />! <br />Phone:) <br />6. <br />3 <br />9. <br />i <br />potato salad, eggs. <br />7. <br />8 <br />I <br />SAN JOAQUIN <br />COUNTY <br />.. <br />if <br />HI <br />contro. tor the hot holding of aH potentially hazardous foods above <br />0"Sterno & hotel trays <br /> Steam table & lids <br /> Other (specify) <br />potentially hazardous food include: <br />— h and dairy products.meats, tamales, cooked beans, rice, <br />™?M2Haze"°" A^nue, Stockion. California osmr, t , <br />07/3/17 '-'‘•iiornta 95205 | T 209 468-3420 I F ?na <br />Po9070'1’ 209 464-0138 | www.sjcehd.com <br />>££5x1 £ S r r V wt-r ■ temp event app <br />TEMPORARY FOOD VENDOR’S APPLICATION <br />All food vendors (both for profit and non-profit) are required to return a signed and completed copy of this checKlist.to . r <br />ihe festival coordinator three (3) weeks prior to this event. , - Af , <br />1 .Name of Event: C 0 1 Date(s): j I \0' <br />The following is information about my orgamzation/business: <br />Name of orgamzation/business: <br />Address: ^0 <br /> Alternate: ( <br />List food to be sold or given to the public:____ <br />I am providing food that is NOT prepared at home: fcTYes No <br />All food is prepared on-site or is from approved commercial facilities; HYes No <br />Name of facility: Phone:J%7f ) 55 <br />Mdressotfacihtyy^/ ____ __ ___ <br />' Tust and ’th^pubHc^ W',h f0,,0Win9: (,° protect my unPackaged food and food-preparation areas from flies, <br /> A booth with walls and ceiling constructed of either wood, canvas, plastic similar material and fine mesh fiv <br />XhaTcleanTfr ely ®ncl0SI"9 oper' food areas- 11 wil1 also have a smooth and cleanable floor (concrete <br />aS-from> the public aCCep,ab'e) 3nd co"slructed operate food and food preparation <br />(2^her (specify): Ar < <br />N:te: sss which <br />Woved water for drinking. utenBil and hand washing will be provided in my booth by the Mowing methods: <br />0 Apprpvecj bottled water. <br />C^On-sHe hose bib that is connected to a potable water source. <br /> Other (specify): ____ <br />^m'nC'tyiS provided for mV booth7useT^es rTNo------------------------------------------- --------------------- <br />' 6 ,he hot and co,d holdin9 o'po,en,iaiiy h— <br />O Camp stove <br />D Double steamer <br /> Electric stove top <br />Note: Examples of <br />vegetables, <br />'e <br />FC' <br />I■hl