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Environmental Health Department <br />Date(s). <br />1. <br />2. <br />3. <br />5. <br />6. <br />Electricity is provided for my Moth's use: <br />meats, tamalss. cooksd beans, rice. <br />7. <br />8. <br />9. <br />SAN JOAOUIN <br />------COUNTY------ <br />Grr=' TEMPORARY FOOD VENDOR’S APPLICATION <br />A,, food vendors (both for profit and non-proflt) are required to return a signed and completed copy of this checK.ist to <br />{he festival coordinator three (3) weeks prior to this event. <br />1. Name of Event: 1 -----------r <br />The following is infonnation about my organization/buslness: <br />Name of nrganization/businessrV^^ \ 1X <br />Address: ---------------- <br />Phone: () AAA'1311A---------------— Al“: < <br />Ust food to be sold or given to the publicC\; ^1 PT <br />I am providing food that is NOT prepared at home0 Yes <br />dust and the public) <br /> A woih ««h *3^ •V “i“"9 C°"Sl,UC^!aeX' arw Kox <br />nnt fflauired to provide enclosed booths are those which sell beverages from <br />App^A, „„ ««»».«— •"« »•“ *• “ P"“a 'n ” •" ““™ m“X“' <br />^Approved bottled water. <br /> On-site hose bib that is connected to a potable water source. <br />“rTTH6 ,he h0'and °0W hOW'n8 0’ f"l> h8Zafd0US <br />, xs the ho' h°idinfl o'811 po,en,iai,y ha2ardous 8bove <br /> c^p st ove Stemo & hotel trays Steam table & lids <br /> Double steamer Efother (specify) V6t& <br /> Electric stove top O <br />s a™. I S»i»a. »!»l T »» I ’ ” <6“'” 1 ~ "“iStK <br />EHD 1S-02 <br />07/01/2024