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Environmental Health Department 1.Date(s): 2. Address: Phone: 3. 4. 5. 6. On-site hose bib that is connected to a potable water source. the hot and cold holding of potentially hazardous 9. meats, tamales, cooked beans, rice, TEMP EVENT APP 5 7. 8. Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods: ''^fApproved bottled water. Sterno & hotel trays Steam table & lids Other (specify) Other (specify): ____________ Note: The only operations not required to provide enclosed booths are those which sell beverages from approved dispensers, or prepackaged foods from approved sources. 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. 1. Name of Event: (SV HI UH Date(s): 1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov^rg/ehd EHD 16-02 Page 7 of 11 TEMP EVENT A! 07/01/2025 Other (specify):____________ Electricity is provided for my booth's use:'0^i/'es No I am providing an accurate probe thermometep-to measure foods during all times of booth operation ^Hves No I am providing the following hot temperature control for the hot holding of all potentially hazardous foods above 135°F: HCamp stove Double steamer Electric stove top SANsJOAQUIN 1 iLiJ ------COUNT Y Greatness grows here. TEMPORARY FOOD VENDOR’S APPLICATION The following is information about my organization/business: Name of organization/business: P-P-V X- (510) |— Alternate: (6^0 ) V - g'X'X'T— List food to be sold or given to the public:. I am providing food that is NOT prepared at home: 'tJ'Yes No All food is prepared on-site or is from approved commercial facilities: E Yes No t Name of facility: IPP-BAk) X Phone: (5|0) I • C Address of facility: ~5S4? lO Zj-YOIhSt) C _________ I am providing a booth with the following: (to protect my unpackaged food and food-preparation areas from flies, dust and the public) 'Q^/Cbooth 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.