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Environmental Health Department TEMPORARY FOOD VENDOR’S APPLICATION Date(S): 06/06/20261.1. Name of Event: 2.The following is information about my organization/business: BUBBASName of organization/business: 2502 WARLOW LN, STOCKTON, CA 95206Address: ( 209 ) 601-8894 Alternate: (Phone:) List food to be sold or given to the public: 3. 4. 5. Other (specify): Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods:6. 0 Approved bottled water. 9. meats, tamales, cooked beans, rice, 7. 8. E3 A booth with walls and ceiling constructed of either wood, canvas, plastic, similar material and fine mesh fly screening, completely enclosing open food areas. It will also have a smooth and cleanable floor (concrete, asphalt, clean tarps and smooth wood are acceptable) and constructed to separate food and food preparation areas from the public. Note: The only operations not required to provide enclosed booths are those which sell beverages from approved dispensers, or prepackaged foods from approved sources. Sterno & hotel trays Steam table & lids El Other (specify) PROPANE DEEP FRYER SAN JOAQUIN -COUNTY- I am providing food that is NOT prepared at home: S Yes No All food is prepared on-site or is from approved commercial facilities: Q Yes No Name of facility: STOCKTON COMMUNITY KITCHEN Phone: ( 209) 949-2104 Address of facility: 110 N EL DORADO ST, STOCKTON, CA 95202 I am providing a booth with the following: (to protect my unpackaged food and food-preparation areas from flies, dust and the public) Note: Examples of potentially hazardous food include: vegetables, potato salad, eggs, and dairy products. All food vendors (both for profit and non-profit) are required to return a signed and completed copy of this checklist to the festival coordinator three (3) weeks prior to this event. MTAAC: MUAY THAI AMATEUR ATHLETIC CIRCUIT foods during all times of booth operation: Yes No I am providing the following hot temperature control for the hot holding of all potentially hazardous foods above 135°F: H Camp stove Double steamer Electric stove top On-site hose bib that is connected to a potable water source. rxzi z -A x WARM WATER HANDWASHING STATION, UTENSIL CLEANING STATION El Other (specify):___________________________________________________ Electricity is provided for my booth’s use: El Yes No I am providing an accurate probe thermometer to measure the hot and cold holding of potentially hazardous