Laserfiche WebLink
.. SAN JOAQUIN COUNTY <br /> In <br /> ENVIORMENTAL HEALTH DEPARTMENT <br /> • 1868 East Hazelton Avenue,Stockton,California 95205 <br /> Business: (209)468-3420 <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 <br /> checklist to the festival coordinator three(3)weeks prior to this event. <br /> 1. Name of Event: C4,1 kt MU5 � � <br /> File following is intbrmation about my organ ization s: I <br /> Name oforganization/business: .. Frsl� I __Ca&� - �__-- <br /> Address: 734•/f /�.�,�n f /�vrflG �j/tS <br /> Phone(40?,)50'�- �Zy Alternate: --- <br /> 3. List food to be sold or given to the public: 17ze6s even dirs,Mt 5 �yCs <br /> c 4s / t.c>ate r <br /> 4. 1 am providing food that is NOT prepared at home: K Yes [ ] No <br /> All tbod is prepared on-site or is from approved commercial facilities:K] Yes [ ] No <br /> Name of facility: ,c <� Phone: 09/SoS-GS f <br /> Address of facility: ,fag /avdr, -3� , ✓el4a-ti l'oq <br /> • . 1 am providing a booth with the following: (to protect my unpackaged food and food-preparation areas from <br /> flies.dust and the public) <br /> [ ) A booth with walls and ceiling constructed of either wood,canvas,plastic,similar material and fine <br /> mesh fly screening, completely enclosing open food areas. It will also have a smooth and cleanable floor <br /> (concrete.asphalt,clean tarps and smooth wood are acceptable)and constructed to separate food and food <br /> preparation areas from the public. <br /> ( ] Other(specify): <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 /> 6. Approved water for drinking, utensil and hand washing will be provided in my booth by the following <br /> methods: <br /> (�] Approved bottled water. <br /> [ J On-site hose bib that is connected to a potable water source. <br /> f ] Other(specify): <br /> 7. Electricity is provided for my booth's use: Yes [ ] No <br /> 8. 1 am providing an accurate probe thermometer to measure the hot and cold holding of potentially hazardous <br /> foods during all time of booth operation: [x( Yes j ] No <br /> 9. I am providing the following hot temperature control for the hot holding of all potentially hazardous foods <br /> above 135 degrees Fahrenheit: <br /> [ ] Camp Stove PCI Double steamer [ J Electric stove top <br /> . [ ]Sterna&hotel trays [ J Steam table& lids [ J Other(specify): <br /> Note: Examples of potentially hazardous food include: meats,tamales,cooked beans, rice vegetables. <br /> potato salad,eggs and dairy products. <br />