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Aug. 11.202 1 5:27PM No. 0324 P. 3 <br />Environmental Health Department <br />All food vendors (both for profit and non-profit) are required to return <br />1. <br />2. <br />Address: <br />3. <br />4. <br />5. <br />6. <br />9. <br />8. <br />Name of organization/business; <br />RO Box 1287. Tracy, CA 95378 <br />Alternate: (209 ) _329-6HJ----------------------------- <br />Hamburgers, Nachos, Baked Potatoes, Candy, Chips, Bottled Drinks <br />the festival coordinator three (3) weeks prior to this event. <br />1. Name of Event: Kimball High School Football Games <br />The following is information about my organization/business. <br />Tracy Sunrise Rotary <br />1068 E. Hazelton Avenue | Stockton, California 95205 | <br />Received Time2 Aug. 11. 2021 5:15PM No. 6859 <br />uur i a/ i <br />Phone: (209 ) <br />List food to be sold or given to the public: <br />I am providing food that is NOT prepared at home: S^fes □ No <br />All food is prepared on-site or Is from approved commercial facilities: M Yes No <br /> <br />Name of facility: Kimball High School Snack Bar-----------------------Phone: ( 209 ) 832-6500----------------- ------ <br />of facilitv 3200 Jaguar Hun, Tracy, CA 95377------- ---------------------——-------— , “7" «. <br />1 am providing a booth with the following: (to protect my unpackaged food and food-preparation areas from flies, <br />dust and the public) <br /> A booth with walls and celling constructed of either wood canvas, plastic, similar matenal andfine imesMy <br />S tS"^ toed pJaparation <br />areas from the public. <br />Brother (specify): _We <br />only operations not required to provide enclosed booths <br />SANJOAOUIN <br />------COUNTY------- <br />Greatness grows here. <br />TEMPORARY FOOD VENDOR’S APPLICATION <br />a signed and completed copy of this checklist to <br />-- ■ - 209 468-3420 1 F 209 464-0138 | www.sjgov.org/ehd <br />•,.7/ TEMP EVENT APRPage 7 of 11 <br />1 am providing the <br />135“F: <br />[~] Camp stove <br /> Double steamer <br /> Electric stove top <br />Note: Examples of potentially hazardous food include: <br />vegetables, potato salad, eggs, and dairy products. <br />are using the snack bar building next to the high s chpp[stadium------------------------------- <br />Note: The only operations not required to proviue enutooeu LoUlI.s are those which sell beverages from <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 /><Kpproved bottled water. <br />■gfon-site hose bib that is connected to a potable water source. <br /> nAto(s):^7/2^;3/21,-!/17/21' <br />9/24/21,10/15/21 <br />pX ■TTno±A?mNiSUre lhe bo. =nd cold hoidlng of po.enlla.y hazardous <br />foods during a« 'XtgTofT^X^ hot hoidlng of all potentiaily hazardous foods above <br /> Sterno & hotel trays <br /> Steam table & lids <br />3ther (specify) Warming trays <br />meats, tamales, cooked beans, rice,