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Environmental Health Department 1.I.Name of Event:Date(s): 2. of organization/business: Address: Phone:( Alternate:() 3.List ood 4. Address of facility: 5. Other (specify): 6.Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods: Approved bottled water. On-site hose bib that is connected to a potable water source. Other (specify): 7. 8. 4^ A booth 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. Note: The only operations not required to provide enclosed booths are those which sell beverages from approved dispensers, or prepackaged foods from approved sources. I am providing a booth with the following: (to protect my unpackaged food and food-preparation areas from flies, dust and the public) SAN JOAQUIN — COUNTY— Greatness grows here. TEMPORARY FOOD VENDOR’S APPLICATION Electricity is provided for my booth’s use: pfYes No I am providing an accurate probe thermometer to measure the hot and cold holding of potentially hazardous foods during all times of booth operation: Yes No 1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd EHD 16-02 Page 7 of 12 TEMP EVENT APP 07/01/2025 The following is information about my organization/business: Name 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. ion to be sold or given to the public: I am providing food that is NOT prepared at home: Yes^J No l/\ll food is prepared on-site^or is from approved commercial facilities: Yes □ No Name of facility:Phone: ()