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Environmental Health Department TEMPORARY FOOD VENDOR’S APPLICATION Date(s):1. 2. Address: Phone: IList food to be sold or given to the public:3. 4 5. Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods:6. Approved bottled water, 9. meats, tamales, cooked beans, rice, 7, 8. Sterno & hotel trays Steam table & lids F ] Other (specify) 1868 L. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 1 www.sjgov.org/ehd EHD W 02 Page 7 of 11 TEMP EVENT APP 06'19/19 pother (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. *=207 SAN JOAQUIN ( r 11 I N T Y The following is information about my organization/business: Name of organization/business: CrepeTea P.O. Box 692012 Stockton ca 95269 200.871-6476 Potable water on trailer__________ Yes El No etpr to measure the hot and cold holding of potentially hazardous K Yes No _______ Alternate: ( ) Crepes & boba tea Note: Examples of potentially hazardous food include: vegetables, potato salad, eggs, and dairy products. [ 1 On-site hose bib that is connected to a potable water source. ^Other (specify): Electricity is provided for my booth’s use: I am providing an accurate probe thermdr foods during all times of booth operation: I am providing the following hot temperature control for the hot holding of all potentially hazardous foods above 135T: Camp stove Double steamer [ J Electric stove top 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.0.Christmas at the park Date(s): Dec, 7 2024 I am providing food that is NOT prepared at home: Yes No All food is prepared on-sitp or is fron? approved commercial facilitiesy.) Yes No Name of faciMy: CallTOmia frlJCk WaSTT Thone: f 209 464'9707 Addressoifacility: 730 Oct ifomia St, Stockton, CA 95206 I am providing a booth with the following: (to protect my unpackaged food and food-preparation areas from flies, dust and the public) )£] 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. Fond trailpr_________________________