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9PM City of Stcxkton 2099378845 page 5 <br /> temp_food_aPP_main 2.Jpg <br /> 1 <br /> TEMPORARY FOOD VENDOR'S APPLICATION <br /> Ali feed vendors(both for profit and non-profit)are required t0 return a Signed arty Oprppleted copy of this checklist to <br /> the Festiva!coordinator three p)weeks prior to this_event. <br /> ! '• �.Name of Even t: 6yi1Lt t'[5��\ 2 <br /> Date:($): <br /> r 2• The fokowing is informaton about my organ ization/business: 4114 <br /> Name of orgsnlzetlonJbus.ness: <br /> Phone: ( l (lD) (1 49 <br /> 3 List food to be sold or given to the pubicC l ��Vik ('' (` <br /> ' c y,0 Caus <br /> �• 'am providing food that is N_QT prepared at homexyes[]No <br /> All food Is prepared on-site or is from approved commercial facili;ies:fYes❑No <br /> Name of facility: S1�1C1(� t �{nG, <br /> Address of facif ty. Phone: <br /> $ 1 am prodding a booth with the feNowing (to p;otect my unpackeged food and food-preparation areas from flies, <br /> dust and the public) <br /> JIA booth with wells and ceiling constructed of either wood, canvas,plastic,similar material and fine mesh fly <br /> reening, completely enclosing open food areas. It Will also have a smooth and cleanable floor(concrete, <br /> asphalt,Clean tarps and smooth wood are acceptable)and constructed to separate food and food preparation <br /> areas from the public, <br /> J Other(specify), <br /> Note: The only operations not required to provide enclosed booths are those whlCh Sell beverages from <br /> approved dispensers, or prepackaged foods from approved sources. <br /> 6. Approved water for drinking.utens;l and hand washing will be provided in my booth by the following methods: <br /> by Approved bottled water. <br /> `pickOn-site hose bib that is connected to a potable water source. <br /> Other(specify): ` W t'Or w <br /> 7 Electricity is provided for my booth's use;%.Yes❑No Q Si iPv14 qQ►1it�C�}-U� <br /> am providing an accurate probe them►am r to measure the not and cold holding of potentially hazardous <br /> foods during aft times of booth operation:5Yes❑No <br /> R 1 am 5 oviding the following hot temperature control for the hot holding of all potentially hezardous foods above <br /> [2 camp stove ❑Stemo&hotel trays <br /> ❑Double steamer ❑Steam table&Ilds <br /> C]Etactnc stove top Other(specify) N �0� (�S <br /> Note: Examples of potentlafly hazardous food Include: meats, tamales, cooked beans, rice, <br /> vegetables,potato salad,eggs,and dairy products, <br /> °Nt 1642 <br /> I114/14 Pap•'r.4 11 <br /> TFIutP&VENT APF <br /> https://rnail.google-conVmaillu/oi?pg-t#inbox?projector-1 <br /> in <br />