Laserfiche WebLink
Environmental Health Department <br />1. Name of Event:1. <br />2 <br />Tracy Ca 95304Address <br />List food to be sold or given to foe public: <br />4. <br />5 <br /> Ofoer (specify): <br />Approved water for drinking, utensil and hand washing wtf be provided in my booth by the following methods:6 <br />^Approved bottled water. <br /> On-site hose bfo that a connected to a potable water source. <br />9 <br />meats, tamales, cooitod beans, rice. <br />Scanned with CamScanner <br />Note: The only operations not requtfed to provide enclosed booms are those which sei beverages from <br />approved dispensers, or prepackaged foods from approved sources <br />7. <br />8 <br /> Stemo & hotel frays <br />p Steam table Abd* <br /> Ofoer (specify) <br />Al food vendors (both for profit and non-profrl) are required to return a signed and completed copy of ttws checkhst to <br />the fosbval coonfrnator throe (3) weeks poor to fote event <br />River islands farmers market <br /> Ofoer (speofy): <br />Electricity is provided for my boofo s use: <br />I am proMdmg an accurate probe therm <br />1868 E Hazelton Avenue | Stockton. Cahfocma 95205 | T 209 468-3420 | F 209 464-0138 | www sjcehd com <br />EHOIMtt P«a»7af11 TEMP EVENT Are <br />Phone: ( ) 209-321-0934 Alternate: ( ) <br />Pulled pork, Tri Tip, pork loin, Linguica, nachos, beans, potato salad, bacon wrapped jalapefios, ribs, chii <br />3. .............................. <br />Note: Examples of potentially hazardous food Include: <br />vegetebtea, potato salad, eggs, and dairy products. <br />£] A booth with wals and oe*ng constructed of either wood, canvas, piasbc. similar material and fine mesh fry <br />^oeenmg. completely endosmg food areas. It wd also have a smooth and deanable floor (concrete, <br />asphalt, dean tarps and smooth wood are acceptable) and constructed to separate food and food preparation <br />areas from the pubbc <br />SAN JOAQUIN <br />COUNTY <br />GrtalntM a'om hert <br />TEMPORARY FOOD VENDOR'S APPLICATION <br />I am providing food that is NOT prepared at homo: Q^Tes No <br />Al food « prepared on-ste or is from approved commercial fadMtes: ^Yes No <br />Name of tacAty Phone: ( ) <br />Address of facAty <br />I am providing a boofo wSh foe fo*owmg: (to protect my unpackaged food and food-preparation areas from fbes. <br />dust and foe pubfrc) <br />o^.jjune 5,2019 <br />The folowing is information about my organizabonfoustoess: <br />Name of orgwiczatiorVbusmess Speer family bbq <br />27715 South Banta road <br />Yes UNo <br />•ter to measure foe hot and cold holding of potenbaly hazardous <br />foods during al times of booth operation: jyf Yes No <br />I am provxfrng the folowing hot temperature control for the hot hokfrng of al potenbaly hazardous foods above <br />135*F: <br /> Camp stove <br /> Double steamer <br /> Electric stove top