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I <br /> <br /> - ..A <br />Environmental Health Department <br />VVc Date(s). ^'21.—2^__ <br />1. <br />2 <br />Phone <br />3. <br />4 <br />5. <br /> <br />6. <br /> Other (specify): <br />9. <br />•w <br />> <br />■ <br />I <br /> Other (specify).—-------------------- <br />Note: The only operations not required to provide enclosed booths <br />Q Approved bottled water. <br /> On-site hose bib that is connected to a potable water source <br />meats, tamales, cooked beans, rice <br />1668 6 Hazelton Avenue | <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 />Stockton. California 952051 T 209 468-34201 F 209 464-0138 | <br />Pao«7°*11 <br />- ’ <br />Alternate: ( )______ <br />8 l^m'Traviding^n Curate p“be themometer to (Xsure the hot and cold holding of potentially hazardous <br />! “X9 the fXwinX^XTXe^nlrol for the hot holding of all potentially hazardous foods above <br />135°F' <br /> Camp stove sterri0 & hotel trays <br /> Double steamer Steam table & lids <br /> Electric stove top Other (specify) <br />Note- Examples of potentially hazardous food include: <br />vegetans, potato salad, eggs, and daity products. <br />SAN JOAQUIN <br />------COUNTY------ <br />Cm« alfitMs yio'ts hfr<». <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 checkh <br />the festival coordinator three (3) weeks pnor to this event. <br />1.Name of Event:ifAilg fittV-g-V c»-> <br />The following is infonnation about my orgamzation/busmess: <br />Name of organization/business: <br />Address <br />8n^oZ <br />List food to be sold or given to the public: <br />I am providing food that is NOT prepared at home: Yes K No <br />All food is prepared on-site or is from approved commercial facilities: Yes <br />Name of facility ____________________—-----------Phone: (--------)--------------------------------- <br /> Address of facility: _________________—---------------------------------- -— ------------- <br />I am providing a booth with the following: (to protect my unpackaged food and food-preparation areas trom me . <br />dust and the public) <br /> A 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.