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Gmail - IFF7/16/24, 2:23 PM <br />Environmental Health DepartmentSANJOAOUIN <br />TEMPORARY FOOD VENDOR’S APPLICATION <br />July 26th & 27thDateisj1 <br />2 <br />AMress <br />Phone <br />3 <br />4 <br />5 <br />Approved -vater for dnnking utensd and hand washing will be provided in my booth by the foitowng methods6 <br />3 Approved bottled water <br />Q On-site hose b;b that is connected to a potable water source <br />9 <br />Please let me know if you received my TFF thank you <br />https://mail.google.com/mail/u/0/?ik=056fe5b4de&view=pt&search=all&permthid=thread-f:1804170426910067046&simpl=msg-f:180417042691006704...5/6 <br />7 <br />8 <br />O Sterno & hotel trays <br /> Steam table & lids <br /> Othef (specify) <br /> Other (.specify) —---------------------------------------- <br />Not®: The only operations not required to provide enclosed booths are those when se be.erages from <br />approved dispensers or prepackaged foods from approved sources <br />1868 E Hazerton A.enue | Stockton California 95205 | T 209 468-3420) F 209 464-0138 www S;gov org ehd <br />I HD 1642 riMPIVtHTApP <br />c<5^-^_____ <br /> - 1 <br />The following is information about my orgamzation/business <br /> Alternate ( 7 L <br />5______ <br />Note: Examples of potentially hazardous food include: <br />vegetables, potato salad, eggs, and dairy products <br />A booth with wails and ceiling constructed of either wood, canvas plastic sim ar mate'a' 3- - ‘ ne " es y <br />screening completely enclosing open food areas It will also have a smooth and cJeanac-e floor concrete <br />asphalt, dean tarps and smooth wood are acceptable) and constructed to sepa'ate food a-d food preparation <br />areas from the public <br />Al! *ood vendors (both for profit and non-profit) are required to return a signed and completed copy of this chec. st ’o <br />the festival coordinator three (3 wwks pnor to this event <br />1 Name of Event Escalon Park Fete <br />Name of organizatKjrvbusiness »rs v ci <br />• : UC Vr.x Vx S-V <br />____ <br />List food to be sold or given to the pubic. <br />I am provi ng food that is NOT prepared at home O Yes 53 No <br />Ail food is prepa'ed on-srte or is from approved commercial facilities [_j Yes No <br />Name of facility Phone j-------)——— ------------------------ <br />Address of facility .......................................................—------------------------------------ <br />l am providing a booth with the following (to protect my unpackaged food and fooa-preparabon areas from f!-es <br />dust and the pubic) <br />moats, tamales, cooked beans, rice, <br /> Other (specify) -------- -----------------------------------------------------------—. ------------ <br />Electnaty is provided for my booth's use Yes No <br />I am providing an accurate probe thermometer to measure the hot and cold holding of potentially hazardous <br />foods during all times of booth operation Yes No <br />I am providing the following not temperature control for the hot holding of all potentially hazardous foods above <br />135 F <br />O Camp stove <br /> Double steamer <br /> Electric stove top