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SANJOAHIN Environmental Health Department <br /> COIJN-%, <br /> TEMPORARY FOOD VENDOR'S APPLICATION <br /> All food vendors iboth for prat; v;d non-profit; are rea.lred to retJrn a signed arc Gompletec comfy of this rhec_ktist to <br /> the festivai coordinator tec f3i-Airs prior to this event <br /> 1 1 Narle of Event: Beef and Taco Festival <br /> le <br /> T t1C tcdlow'ng i5 n`o►matiori etiDu:my off13r1 7;llinn t:uz��cs <br /> Name of organ¢strcn.'b,m-inrrss 131NO Boba -- - <br /> Adds 4654 E Donner Ave, Fresno, CA 93726 <br /> Ph" 559-270-3585 _ Xtemaie: ; 1 559-270-3585 - - <br /> 3 List food to be soli or,given to the public. Boba Drinks & Kuttle Corn <br /> 4 I;,rr prn•:rlrng:ryod t^a-•s NOT L-epare-J at home W Yes I No <br /> i4i1 `find in prrparc,-on-site or is t-r_n-i approved commercial fairilitns ®Yes G No <br /> `ia nFl c� Fret.-are d on si;r, -- Phor*- -- <br /> A.ddress at tacilry <br /> a ' f7r]vrdiny a baalh wilh n the folknving: (to protect my unpacksged food and food-prepararoon areas from fib, <br /> dus'.and the cublic; <br /> V, A booth w"h viall. and ;;oiling cans.ructec at ache'wood. canvas f:l;tslu: irr far maileria and fine mesh ily <br /> !:cry-,-7q comFieter,, enclosing open 1wd are:a:s It wit also have a smooth ar-cl clear•abie fU:r (::cnrrcic, <br /> asphalt _lean tarp6 and srn:r.Ah wwd are acceptab�e) and c--strucled Ic: Fccd and food Greparatci <br /> H'eds'r•4xn 1hr-ptibir <br /> Note- -ne o'-'y clinerations ^cY. rec:uirv(i Ir prrrviir_. enclosed -3ih5 are those whiC" sin he r-w F'cm <br /> approved 4ispersers orprepac"ge:i toots from vp.fc cd sources. <br /> Approved-hater for dunking,utefsil and t!and ++as-nq-hill be Drc+vided in my noath by toes l0low^ng meChcas: <br /> Y' Approved~crated water. <br /> L Or,-sits hose ryc that is'_cnn&c1!&d to a p(.0)kI w;it<r srurCje <br /> F1 G11lei {s aec:ifY: <br /> .7 Fkx;tnrity is Drrmfied to,my bootti's use 2 Ycs L_- Nu <br /> r? I am prorvidrrng, an accurate preoe thernryrietes In rnRas.:rn the h;; and cold ncrding of po*Mially hazardous <br /> foods durirc;all trees,at t)x. h operation. V. Ye* ] No <br /> 9 1 am providing thr.fnllowinq hot temperature cont'vl for Vie but ncidiny%Y all pcleriially hazardous foocls move <br /> 135T <br /> i]Camp stove Ej !-�tnrnr v Fatel trays <br /> ❑Dowbw s40ti M L Steam tattle&I►ds <br /> Ele,=c stow!tbp V tither(sD=_.ciI`} Na hot fore <br /> Note: Examples of potentially hazardous food include: meats, tamales, cooked beans. rice- <br /> vegetables,potato:salad,eggs. and dairy products, <br /> 1860 E. Hazellion Avenue i Stockton.Calito--a 95205 1 T 209 468-34201 F 209 464-0138 1 www sigov r,_-�rghd <br /> Eeo I&W PW-0111 TEW EVENT APP <br /> aerzudo¢a <br />