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R’S APPLICATION <br />jYes <br />[ ] Sterna & hotel trays [ ] Steam table & lids <br />Tim <br />SAN JOAQUIN COUNTY <br />ENVIORMENTAL HEALTILDEP ARTMENT <br />1868 Eart HazeKon Avenue, Stockton, California 95205 <br />Bartneaa: (209)468^420 <br />4. I am providing food tort is NOT prepared at home: KJYes [ JNo <br />AU food is prepared on-site or is from approved commercial fecilities: M Yes [JNo <br />Name of facility*. Phone: 2^—Z*2 7 /~.._ <br />Addreaa of facility: 5 ------------- <br />I am providing a booth with the following: (to protect my unpeckaged food and food-preparation areas from <br />flies, dust and the public) <br />A booth with walls and ceiling constructed ofeither wood, canvas, plastic, similar material and fine <br />mwh 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 operatioBS not required to provide enclosed booths are those which seU beverages from <br />TEMPORARY FOOD VEN <br />AU food vendors (both for profit and ntm-jnofit) are required to return a signed and completed copy of this <br />checWisrto foe festival coordinator three (3) weeks prior to this event <br />1. Name of Event: Datefs); Z^- <br />2. The following is information about my organization/business: x p Name of organization/business: ------------------- <br />Address: —----------------------- <br />Phone: Alternate: _2&_2 ---------------------------------------- <br />3. List food to be sold or given to the public: ----------------- <br />[]No <br />foe hot and cold holding of potentially hazardous <br />‘ ‘ t^es [JNo <br />I am providing the following hot temperature control for the hot holding of all poteniiaUy hazardous foods <br />above 135 degrees Fahrenheit: <br />Camp Stove [^Double steamer [ ] Electric stove top <br />[ ] Stemo & hotel trays [ ] Steam table & lids { ] Other (specify): —----------------------------- <br />Note: Examples of potentially hazardous food include: meats, tamales, cooked beans, rice vegetables, <br />potato salad, eggs and dairy products. <br />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 foe following <br />methods: <br />M Approved bottled water. <br />M On-site hose bib that is connected to a potable water source. <br />[ ] Other (specify): <br />7. Electricity is provided for my booth’s use: f <br />8. I am providing an accurate probe thermometer to <br />foods during all time of booth operation: | <br />9. ]