Laserfiche WebLink
Environmental Health Department <br />i. <br />2. <br />Phone: <br />3. <br />4. <br />C^q \ - Q7O ( <br />5. <br />6. <br />9. <br />tamales, cooked beans, rice,meats, <br />7. <br />8. <br />-^4^ . t <br />209 464-0138 I www.sjgov.org/ehd <br />TEMP EVENT APP <br />'’l irOP'4'’ <br />Q Approved bottled water. <br />J7] On-site hose bib that is connected to a potable water source. <br />■* _________________________________________________________ __________________________________ ____________________________________________________________________ <br /> Other (specify^__________________ ____i=r-------------------------- <br />135°F' <br /> Camp stove □Stemo & hotel trays <br /> Double steamer JZSteam table & lids <br /> Electric stove top d Other (specify) <br />Note: Examples of potentially hazardous food include: <br />vegetables, potato salad, eggs, and dairy products. <br /> Other (specify):---------------------------------------------------------------------- <br />Note: The only operations 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 be provided in my booth by the following methods: <br />1868 E. Hazelton Avenue | Stockton, California 95205J T^209 468 3420 | F <br />SANJOAOUIN <br />-----COUNTY------ <br />Greotness grows u<'-c <br />TEMPORARY FOOD VENDOR’S APPLICATION <br />All food vendors (both for profit and non-profit) are required to return a signed and completed copy of this checkhstjo^ <br />the festival coordinator three (3) weeks prior to this event. <br /> t.Nameof Event: ------DatetsTZg^A^YzZ <br />The following is information about my organization/business: <br /> <br />Nameoforganization/business: <br /> Address: H33.^C)S'2JJ-£--------------------- ------ <br /> <br />(1 “7 Alternate: (^J4^ <br />I am providing food that is NOT prepared at home. 0 Yes O No <br />All food is prepared on-site or is from approved commercial facilities.^Yes <br />Name of facility: C ft C -A -----------------Pho™5- <br />fam providing a booth with the fol^gAprotect my unpaid food and foodZZmt.on areas from flies? <br />dust and the public) <br />A booth with walls and ceiling constmctecI ofeither wood can™, pla«^ "andjm a mesh fly <br />“cie^a^'LTsXt^ Xd are acceptable) and constructed to separate food and food preparation <br />areas from the public.