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Date(s): <br />1. <br />2. <br />3. <br />4. <br />5. <br />which sell beverages from <br />6. <br />A/, <br />9. <br />209 464-0138 | www.sjcehd.corn <br />7. <br />8. <br />(fc Ml <br />— t-hpt-andco^oy of potent hazardous <br />controRor the hot an^»ally hazardous foods above <br />if rd <br />meats, tamales, cooked beans, rice, <br />1 TEMP EVENT APP <br />Environmental Health Department.AlWOMUIN <br />------COUNTY------ <br />Z G'"' temporary food vendors application <br />1. Name of Event:-------------------------------- <br />The following is information about my organization/business: <br />Address: —<----—1 x 3^0 S <br />Alternate: ()-- -------- ~ <br />phone ( --------- <br />List food to be sold or given to the public: <br />I am providing food that is NOT prepared at home: Yes □ N <br />All food is prepared on-site or is from approved commercial <br />Nanreoffaciiity: <br />areas from the public. <br /> Other (specify): —------------------ - —————— <br />X^d S". o^eXed <br />Approved water for drinking, utensil and hand washing will be provided in my booth by the following <br /> Approved bottled water. <br /> On-site hose bib that is connected to a potable w^er source <br />“BEBsi foods during all times of booth operation. UZY L_l^ . <br />I am providing the following hot temperature c_..- - <br /> Camp stove Q Sterno & hotel trays <br />□ Double steamer S?eam table.S // <br /> Electric stove top QOher (specify) <br />.868 E. Hszelion Avenue | S»»~. «>«. ®0S| 1,20. «».3A!» I F