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Date(s).^^P <br />1. <br />2. <br />Address: <br />3. <br />4. <br />5. <br />6. <br />9. <br />7. <br />8. <br />Environmental Health Dep.. <br />\ <br />X- <br />_____ Alternate: ( <br />SAN JOAQUIN <br />' LilfcS' 7 " -COUNTY------ . <br />'''■r-SSY Greotness grow* here. <br />temporary f <br />meats, tamales, cooked beans, rice, <br />209 464-0138 | ^ ^.com^ <br />OOD VENDOR’S APPLICATION <br />ia=&aa=sas=r--~-“-"" <br />tName of Event; <br />The following is information about my organization/business: <br />Name of organization/business: T” <br />°\&\ \<)6XSW\YVj\oV\ VAmA. -yVZ~O <br />p,„. fliinizims— <br />List food to be sold or given to the pubhc: Tun J ptfLT <br />I am providing food that is NOT prepared at home: QTes / <br />All food is prepared on-site or is from approved commerc.^t-es. ® <br />Nameoffacility; <br />□ A booth wlh A3,Is 800 ctii no oonstn^tsd of either PLSrTd SearSSe neo, (concrete. <br />2S “Siil'SS- »** - - -•«“ <br />areas from the public. / / r. <br />/ , yu/ no [ ------------- ----------- <br /> Approved bottled water. <br /> on-site hose bib that is connected to a potable water source. <br />ElecwZvidedf^^^ holding of potently hazardous <br />' “S “ "»• <br /> Camp stove Sterno & hotel trays <br /> Double steamer D Steam table & lids <br />□ Electric stove top Esther (specify) hJ/A <br />U_H„„ Avenue I Stockton, California 95205 | T ,209 468-3420 | F