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SA N J DACE U I N Environmental Health Department TEMPORARY FOOD VENDOR'S APPLICATION 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: Watermelon Fair. oate(s): 6/1/24 2. The following is information about my organization/business: Name of organization lbusiness, Golden State Treats Concessions Address: 245 Long Street Suisun ca 94685 707-999-7757 Phone: ( ) Alternate: ( } 3. List food to be sold or given to the public: Cotton candy 4. I am providing food that is NOT prepared at home:N Yes©No All food is prepared on-site or is from approved commercial facilities: q Yes ❑ No Name of facility_ On slie only Phone: ( ) Andress of facility- 5. 1 am providing a booth with the following: (to protect my unpackaged food and food-preparation areas from flies, dust and the public,) Xaqr, A booth with walls and ceiling constructed of either wood, canvas, plastic, similar material and fine rnesh fly ooning, completely enclosing open food areas. It will also have a smooth and cleanable floor (concrelo, asphalt, clean larps and smooth wood are acceptable) and constructer) to separate food and too(] preparation areas from the public. [Xolher(specdy): Comercial Food both with side walls & serving windows Note: The only operations not required to provide enclosed booths are those which sell beverages from approved dispensers, or prepackaged foods from approved sources 6. Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods: EX Approved bottled water. All []On-situ hoso bit)that is connw*lod to a potable water source. ❑Other(specify): 7. Electricity is provided for my booth's use: Yes❑No 8_ 1 am providing an accurate probe lhermo ter to measure the hot and cold holding of potentially hazardous foods during all times of booth operation)Yes[I No g. 1 am providing the following hot temperature control for the hot holding of all potentially hazardous foods above 135"F: ❑Camp stove ❑Sterno&hotel trays Q Double steamer ❑ Steam table& lids [� Elecl�iiC stove top )a Other (specify) I Note: Examples of potentially hazardoUS food include: Orients, tamales, cooked buns, rice, vegetables,potato salad, eggs, and dairy products. 1668 E Hazelton Avenue I Stockton, California 95) 05 i T 209 468-3420 1 F 209 464-0136 vvwv jgov.0r%Fwl d EHD 1"2 Pao 7 a1 t I TEMP EvENT APP