Laserfiche WebLink
Environmental Health Department <br />TEMPORARY FOOD VENDOR’S APPLICATION <br />1. <br />2. <br />Address: <br />Phone: <br />3. <br />4. <br />5. <br />6. <br />the hot and cold holding of potentially hazardous <br />9. <br />meats, tamales, cooked beans, rice, <br />vegetables, potato salad, eggs, and dairy products. <br />7. <br />8. <br /> Other (specify):__—---------------------------- <br />Note: The only operations not required to provide enclosed booths <br />SAN JOAQUIN <br />■COUN f Y <br />Name of organlzation/business: <br />foods during all times of booth operation <br />I am providing the following hot temperati, <br />•|35°F: _ <br /> Camp stove Sterno & hotel trays <br /> Double steamer Q Steam table & lids <br /> Electric stove top D Other (specify) <br />Note: Examples of potentially hazardous food include: <br /> Other (specify):-----—------------ <br />Electricity is provided for my booth’s use:ZJ Yes [J No <br />I am providing an accurate probe thermforneter to measure <br />............ ‘'n:MYesDNo <br />litpecontrol for the hot holding of all potentially hazardous foods above <br />5 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 /> Approved bottled water. <br />'•U On-site hose bib that Is connected to a potable water source. <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420] F 209 464-0 I38 | w^-sj^E7enN’TAPP <br />EHD 16-02 <br />07/3/17 <br />I am providing food that is NOT prepared at home: YesZJ No / <br />All food is prepared on-site or is from approved commercial facilities: gj Yes No <br />Name of facility: Phone: (-------)--------------------------------— <br /> fam providing a booth with the following: (to protect my unpackaged food and food-preparation areas from flies, <br />dust and the public) <br />pfA booth with walls and celling constructed of either wood, canvas, plastic, similar material and fine mesh fly <br />^screening, 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 />All food vendors (both for profit and non-profit) are required to return a signed and completed copy of this checklist to <br />the festival coordinator three (3) weeks prior to this event. / / <br />1. Name of Event: ---------Date(s): G7/ / 3 <br />The following is information about my organizatlon/business: <br /> <br />(O_______ Alternate: . 3.3/—3SV/-------------- <br /> List food to be sold or given to the public: --------------—-------------—------------------