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SAN JOAQUIN <br />TEMPORARY FOOD VENDOR'S APPLICATION <br />signed and completed copy of ih.s checklist to <br />’ Marne jf Event <br />Pno'io <br />J <br />Other I specify i <br />s <br />th r,i.: .ifi.-i , < lu Iiohj. q f jxiter ’. i'.’v ' irardous <br />\ (' Q <br />t.irnalesNotemeats <br />>i oJ • q. <br />I .1 N' <br />f^yes n No <br /> Phone ( <br />'♦•T.ontfl,i frit fh*» f h) I IffKj .-Ji potor ’ ■ .1’ W feus t ' vhove <br />______Datefe). <br />profit and non-profit) are required to return 3 <br />Note Tn© only operations not required to provide enclosed oooths are those which sell beverages from <br />approved dispensers or prepackaged foods from approved sources <br />'Jtr.fcf fspij/jfy/ ______ _ __ _ _ <br />F '.-1/ i*. pro/id«;d for fiy booth S use ( V <br />1 <if’ ar. arxurale probe thermo^rey <br />'v/Js o Tr.q ail r.mes of txx>th upmatiun <br />.J" |>ro/i<Jr.q •» «. fqiiov/ng riot temperak <br />1 f <br />f.ar’p <br />•.Wfan.ei <br />f tect'v- stove top <br />\XMi ventk'rs (b»jtfi lor { " ‘ <br />les; ^a cixwdmator three (3) weeks prior 10 this event <br />V- A- Pr A 0 OZ A <br />•e fo-inw no s 'nformation about my organizatinn/busmess <br />Name of organization.busmess \JUXkk<\ <br />Address ) <br />’^G^lVCkOl' Alternate C ' <br />List 'cod to bo sotd or given to the public <br />an-, providing food that is NOT prepared at home ^_Yes Q No <br />**•' food is prepaied on-site or is from approved commercial facilities <br />Name ot facility <br />Aodress o’ facility <br />am providing a tiooth wdh the following (to protect my unpackaged food and Ioodj)repa?ation~areas7rom fhes <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 />/cTeer-ng completely enclosing open food areas It will also have a smooth and cleanable floor (concrete, <br />asphai’ clean tarps and smooth wood are acceptable) and constructed to separate food and food preparation <br />areas horr the public <br />I ] Sterna X. ‘ .i<-1 tins <br />| j Shram t.ilii- /■. <br />xr.oi (bp» < if71 <br />E«>mpte» of potentially hazardous food hicludw <br />vagatabtea. potato salad, aggt, and dairy products <br />Environmental Health Department <br />Ha/uikir. 1 '.trx kh„ <br />App'oved water ’0' drinking utensil ano hand wash-ng w. 1 be provided r my boctr- by t»fO low.nq methods <br />^Appro /ed bottled water <br />O’-'Snr- nose bib that s connected to a potaf:'*- watr*' sour e. <br />cooked be.ms. rice <br />it. I. <br />Y '. L Xuivk'A