Laserfiche WebLink
0013OX)>ent£ <br />Date(s): <br />1. <br />O- ?2. <br />Address <br />Phone: <br />3. <br />5. <br />6. <br /> On-site hose bib that is connected to a potable water source. <br />9 <br />meats, tamales, cooked beans, rice. <br />7. <br />8. <br />environme-’'3' H*alth 0<>p; <br />.p plication <br />vendor s a <br />signed and completed copy of <br />Oatets): 5 <br />)____ <br />’Ji— •.<«-««<« "«““o -11*"""* <br />, SESSSS•«-«• '•' “ ’-««* <br />□ Smp stove □ Stemo & hotel trays 7 , 7? <br /> Double steamer Steam table & Ws Z/7 ^7 / <br />□ Electric stove top □ O‘hef (SP^W f <br />Note: Example of potentially hazardoue foodinclude: <br />vegetables, potato salad, eggs, and dairy products. <br />■ Stoeklon. CaWwn« aS20S I T 209 468-3420 I F ».««»» I <br />EHD :6^>2 aW <br />07/01/2024 <br />SAN JOAQUIN <br />------COUNTY------- <br />: .-Otrir^ gro*« hf <br />TEMPORARY food <br />AH food trite . <br />the festival ^atortbreeP)^^^ <br />t .Namo of Event <br />Name of organization^buskte®^— - Z f <br />fitf) <xz___ <br />LisI food to Do^dor given fotbepub* --------- <br />All food is prepared omsrte or is from approved Ptwne: (--------}--------------------------------------- <br />Name cf tidily ____ __—-7-^. __ ~— -----------------------------------asisss "y‘ ——«-• <br />dust and the puWic) .... <br />XJrtxwth wrth wafts and ceiling constructed of either a Imooth and deanatoteXoH^crew. <br />Xd X^abM -nd constructed to separate food and food preparation <br />areas from the public. <br /> Other (specify):----- ---------- --------------------------- ------------------------ <br />. onH/icod booths are those which sell beverages fromMota The only operations not required to provide enclosed booms a <br />approved dispensers, or prepackaged foods from approved sources. <br />Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods <br />ffl'Spproved bottled water.