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image2jpeg <br /> SRN IUAQUIN Environmental Health Department <br /> TEMPORARY FOOD VENDOR'S APPLICATION <br /> l <br /> i!"rtv';4ti'r7Grc .'^.prof.!.11M],fin-prpf,Sl afe n�,]ii�rt.�R7 n!1W" .,• ; r-i �, !r-:.,I_a - -1 r ••. <br /> Manteca par - -palooza <br /> wmq•1 lrltort%y-cn atw m nr�anr:pz(sa'brsr.ess <br /> t.7�ipss <br /> Pr•�� I yr/Z•I �t r.'a'S � �I A3SM1[T1YP _.__ ((<, <br /> } o5t tcy io tie 5Di1 ar giyen to vie rivk: <br /> e l a^i vevoing rood That rs 11QT pr"r!'d at homF ©YB!L rt <br /> Ail rob.%orpparpd Of"W'O1 Is from ap"ood COn'riOM4 ra'11" <br /> vAr-*rr tacj It) �.-- <br /> Pfrcna L��-_� <br /> Agar06:5&iau.dy Areas PmTtiHS <br /> l am prnwjing a twh WTM 1M t011Owsng I to M tl'a <br /> Mow my unpaaged food and kwd-Vavarath'K4 <br /> r;u;pt and the nubkI <br /> G{7at!`*it.wat8 and=e ling WnSITUCted of etrnw wood.canvas "tr,'S.*idar r"00"at aM Rne mesa«V <br /> Sere e71rq ccfnprtcl} cnUos[y open loud aTrtai kdr an0 Cnnstrutled to sat7ara a too[!ash.rood preparat <br /> acphan C*W tams and Sr OMI l Woodare WeVWb <br /> areas from"DJAvk <br /> f,]0mor lspecrry; l—. ..— <br /> Note: The only operatlonS not req,,gCrd so prcwde encloW bWh5 alit those vMCM; seu t"TOges from <br /> apnro•.rrd tllspc•users,or prelackag°j k4odls tram approved;ourpA4 <br /> 6 Arprova c",or for Crnking. ytan5rl and hand washuig will oe p'ovided in my booth toy She hAlowrig mexnods <br /> $ppeoved bCVW Water <br /> E]O!,51te hoso 41b tha'i9 conrN ied to a potabie Water source <br /> [j Other(spovNi -- <br /> 7 Elevrcr:y a provv4e7 for my booth's No <br /> 8 1 ar7r provading an accurate probe therm ter to metastare the hot and cold holding❑t poten0alfq haZardtre <br /> kg*t dun%atl trines of booth operation'ej Yes 0 No <br /> g I aen Wavldintg the tpllow og hot tomperature oorMl for the hbi balding al an potend�artif haLtrd�nis foods abt+' <br /> f]Garnp stove ❑5lerrao howl U�tyS <br /> �I ooub,le steamer SEeanr 130e&11a5 <br /> J�k Stove 14p ❑CiRni r st eCi!/1 <br /> Mate Exanrplfls of psfentlally hazardous food ClUda' meats, tamales. conked bean%. rir <br /> vegetables.potato Salad,eggs.and d.ilry products <br /> S$ H.Ze!10m AYd'ruP rJEC7�kSOt1 ('.a <br /> h6cmlrl 96205 T 1� 1468-3420 F 209 46A-0138 <br /> }a.=kr...y�.rrlds.pw.i:5a$p.'.;•..1.. y�yadr;- <br /> II � <br />