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5.png <br />5-2/25.6 ^ AM <br />Environmental Health Department <br />TEMPORARY FOOD VENDOR'S APPLICATION <br />1 <br />2 <br />3 <br />4 <br />5 <br />6 <br />! <br />I <br />pottH© salad, eggs, and dairy products. <br />7. <br />B. <br />9. <br />Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods <br />fy. Approved bottled water. <br />Q On-sde hose bib that is connected to a potable water source. <br />SUN IQMJUIN <br />COUNI ' - - <br />required to return a signed and completed copy of this checklist to <br />Da!e(s)i <br />Q Other (specify):_____ _______________________________________________ <br />Electricity is provided for my booth's use: Yj Yes QNo <br />I am providing an accurate probe therrriometer to_measure the hot and cold holding of potentially hazardous <br />foods during ail times of booth operation:^ Yes O No <br />I am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br />135’F; _ <br />Q Ceny st Ove Sterno & hotel trays Steam table & lids <br />Q DouWe steamer Other (specify) <br />OBactric stove top O <br />Note: Enamptos of potentially hazardous food include: meats, tamales, cooked beans, rice, <br /> .nFBgDTTSCJnkzfflTprojecto^mmewagePacuaxO.t <br /> A booth with walls and ceiling constructed of either wood, canvas, plastic, similar material and fine mesh fry <br />screening, completely enclosing open food areas. It will also have a smooth and cleanable floor (concrete, <br />asphalt, clean tarps and smooth wood, are acceptable) and constructed to separate food and food preparation <br />areas from the public. , /a <br />w Other (specify): I ] f T <br />Note: The only operations not required to j^teVide enclosed booths are those which sell beverages from <br />approved dispensers, or prepackaged foods from approved sources. <br />All food vendors (both tot profit and non-profit) are <br />the festival coordinator three (3) weeks prior to this event. <br />1 Name of Even. <br />168 E- HazaWto Avwue I Stockton. California 95205 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />«iui? TEMP EVENT KPP <br />57101/2024 <br />The following is information about my organization/business <br />Name of organization/business 3'as Tacos <br />Address, (jr>rc>n S't ______ <br />Phone: ( 2^ ) U C- -M/ 33 Alternate; ( Zi_Z|) C> < 3> 2. <br />List food to be sold or given to the public: \ 61 L() f /~i It/) \ ■ 5' \ <br />I am providing food that is NOT prepared at homeYes No <br />AH rood is prepared on-site or is from approved commercial facilities^) Yes No <br />Name of facility: (J/n On Phone: 2^I <br />Address of facility; S 6^ <br />am providing a booth with the following: (to protect my unpackaged food and food-preparation areas from flies <br />dust and the public)