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Environmental Health Department <br /> IWs): SEP 14-17, 2023 <br />2. <br />3. <br />—.J. <br />A. <br /><5. <br />6. <br />9. <br />food includo:meats, tamales, cooked beans, rice, <br />7. <br />8. <br />SANJOAOUIN <br />COUN J Y <br />TEMPORARY FOOD VENDOR’S APPLICATION <br />ZT'110 re,urn a and comp,o,od cow of ,h,s “•to <br />1. 1. Name of Event: 1 Ol)' GRAPE FESTIVAL <br />.w"^11®0110'1^'™101 Stockton. California 95205 | T 200 468-34201 F 209 464-0138 | www sicehd con, <br />InflO/oHt TEMP EVEN! API- <br />rhe following is information about my organization/business: <br />Name of organization/business: I i y 5 \aj cgJr I Lj> <br />Address: <br />Alternate: <br />List food to be sold or given to the public: / CiLrn Ct> <br />I am providing food that is NOT prepared at home: |<|. Yes No <br />All food is prepared on-site or Is from approved commercial facilities: 00 Yes | | No <br />Name of facility:-------------------------------------------------------------------Phone:L <br />Address of facility: _ <br />‘ Sand thepuMfcJ1 f0,'0Win9: (t°PrOt0Ct my <br />W A booth with walls and coiling constructed of cither wood, canvas, plastic similar material and fine mosh fiv <br />greening completely enclosing open food areas. It will also have a smooth and cloanablo floor (concrete7 <br />Xs fromTepSc Sm00th W0°d ar° accep,abl0) and “^tructed to separate food and food preparation <br />1.1 Other (specify): <br />N°t0: nnnrnula ^P0^110'18 ',0‘ rofinirod to provide enclosed booths are those which sell beverages from <br />appiovod dispensers, or prepackaged foods from approved sources. <br />Approved water for drinking, utensil and hand washing will bo provided in my booth by the following methods: <br />1^) Approved bottled water. <br />I I On-site hose bib that is connected to a potable water source. <br />I I Other (specify):.. <br />Electricity is provided for my booth's use: |/| Yes | | No <br />' fod hot alld »'d h°ldia9 "'PO'-Hatty hazardous <br />' '’l35PT VIC1//A f°"0Win9 h0' tOmperatUr° conlml for lhe h01 taldi"9 °f a« Potentially hazardous foods above <br />I I Camp stove | | Star no & hotel trays <br />I I Double steamer | | steam table & lids <br />I I Electric stove top [ | other (specify) <br />Noto: Examples of potentially hazardous f : <br />vegetables, potato salad, eggs, and dairy products.