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I nvhoi,H,ontal Health Dcpartir <br />3. <br />5. <br /> <br />6. <br />9. <br />7. <br />8. <br /> Other (specify):_ <br />Note: The only operations <br />accurate probe thermometer <br />,uo ... ..'mes of booth operation-XY- <br />providing the following hot temperature c_ <br /> Sterno & hotel trays <br /> Steam table & lids <br />pother (specify) C.V <br />food include: <br />TEMPORARY POOD <br />»y^vTdo's(bolhfo'the festival coordlnntoi throo (3) <br />1. <br />2. <br />'^Approved bottled water. <br />^On-site hose bib that is connected to a potable water source. <br /> SSy tho hot and cold holding of potential ' - v ■ <br />I am | <br />135°F: <br /> Camp stove <br /> Double steamer <br /> Electric stove top <br />Noto: Examples of potentially 'iaz‘\rJ°^a| prot|Ucts. <br />vegetables, potato salad, eggs, and da y i <br />■ ■ ■ ■ , <br />186f) E Hazelton Avenue | Stockton. California 9520M T (209 468 34 <br />■ .1» art fl'l <br />SANJOAQUIN <br />- - <■ •( >( I hl I <br />F 209 464-0138 | WM.sjcehd <br />■r <br />(7^)Hai-q^-.________Allornato: ( ) <br />__ or n/voiTto tho public: .tXZJLC.\« x o - ■' <br />I etm providfne] food (tint fr> NOT propnrod nt homo: 'feTvon l._| No <br />Al/ food is proporod on-slto or Is from approved commorclnl focMlUmrJ&aYcm U7A No <br />Name of facility: ----------------------------------------------------------- ----- ------------ -------------------------Phone-. J-----------i----------------------------------------------------- <br />Address of facility:--------------------------------------------------------------------------——— ---------— ---------—— ------ <br />I am providing a booth with the following: (to protect my unpackaged food and food-preparatton areas hom Ates. <br />dust and the public) <br />booth with walls and celling constructed of either wood canvas, plastic, similar material and^e, <br />■greening, completely enclosing open food areas. It will also have a smooth and cleanablo noor ...cncr-i, <br />asphalt, clean tarps and smooth wood are acceptable) and constructed to separate food and food .. <br />areas from the public. <br />DcV-sx,^s \ x <br />meats, tatnalos, cooked beans, rice, <br />,.,o „„„ not required to provide enclosed booths are those which sell beverages from <br />approved 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 />vi-.Nixurr, Af’pi |(;a rioti <br />IhK rX"”' '''' ............ ' ’ »’^r <br />I.Nnnio of IHvonl; l-Obl GRAPR nisiiVAl .............. <br />Tho following Is Information nbont my orgtinlznllon/hnslnons <br />Name of organization/bnslncss:. VVc V £ £ \ 03 <br />Address: | <br />Phone: (7L-D ) ______________ Allornato: ( <br />List food to be sold