Laserfiche WebLink
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 checklist to <br /> the festival coordinator three(3)weeks prior to this event. I <br /> 1_ 1.Name of Evem-_LL �`� 7� �t�j �S� Date(s): <br /> 2. The following is information about my organizationtbusiness, <br /> Name of organization/business: L <br /> Address: <br /> Phone: V 5h !!!�j g — L Alternate:(�Z-1g 4)j5- <br /> 3. List food to be sold or given to the public: <br /> 4. 1 am providing food that is NOT prepared at home: Q Yes❑ No <br /> All food is prepared on-site or is from approved commercial facilities:[ Yes❑No <br /> Name of facility: _ = 1 -s; Phone: <br /> Address of facility: <br /> 5. 1 am providing a booth with the following:(to protect my unpackaged food and food-preparation areas from flies, <br /> dust and the public) <br /> [il"A booth with walls and ceiling constructed of either wood, canvas, plastic, similar material and fine mesh fly <br /> screening, completely enclosing open food areas. It will also have a smooth and ckuumble floor (concrete. <br /> asphalt, clean tarps and smooth wood are acceptable) and constructed to separate food and food preparation <br /> areas from the public. <br /> ❑ Other(specify): <br /> Note: The only operations not required to provide enclosed booths are those which sell beverages from <br /> spproved dispensers,or prepackaged foods from approved sources. <br /> 6. Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods: <br /> :Approved bottled water. <br /> e"On-site hose bib that is connected to a Dotable water source. <br /> ❑Other(specify): <br /> 7. Electricity is provided for my booth's use:Q Yes❑No <br /> 8. 1 am providing an accurate probe thermometer to measure the hot and cold holding of potentially hazardous <br /> foods during all times of booth operation:E'Yes❑No <br /> 9. 1 am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br /> 135'G. <br /> Camp stove RStemo&hotel trays <br /> Double steamer ❑Steam table&lids <br /> ❑ Electric stove top ["Other(specify) ,Fy= 7 <br /> Note: Examples of potentially hazardous food include: meats, tamales, cooked beans, rice, <br /> vegetables, potato salad,eggs,and dairy products. <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 ( www.sjcehd.con:EHD 16-02 <br /> 0713117 Page 7 of 11 TEMP EVENT AD= <br />