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SAN4JOAQUIN <br /> COUNTY <br /> GrecG of as crows here. <br /> TEMPORARY FOOD VENDOR'S APPLICATION <br /> All food vendors (both for profit and non-profit) are required to return a signed and completed copy of this checklist <br /> to the festival coordinator three(3)weeks prior to this event. <br /> 1. 1. Name of Event: <br /> Date(s): 7 j r(2,1 v <br /> 2. The following is information about my organization/business: <br /> Name of organization/business: e V_f C j4trjy6r, <br /> Address.- <br /> Phone: ( " } ! Alternate: ( } <br /> 3_List food to be sold or given to the public: V--k �7 � <br /> 6 c V,...,Z(t z v, <br /> 4. 1 am providing food that is NOT prepared at home: G Yes Eli/No <br /> All food is prepared on-site or is from approved commercial facilities. Ek4 0 No <br /> Name of facility: T 'V_ V, C-ft," Phone:j?-/? <br /> Address of facility: ( 7 L S t1 4-c <br /> 5. 1 am providing a booth with the following: (to protect my unpackaged food and food-preparation areas from <br /> flies, dust and the public) <br /> 0 A booth with walls and ceiling constructed of either wood, canvas, plastic, similar material and fine mesh <br /> fly 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 /> ❑ Other(specify): <br /> Note: The only operations not required to provide enclosed booths are those which sell beverages from <br /> approved dispensers, or prepackaged foods from approved sources. <br /> 6. Approved water for drinking, utensil and hand washing will be provided in my booth by the following <br /> methods: <br /> Approved bottled water. <br /> 0 On-site hose bib that is connected to a potable water source. <br /> 0 Other(specify): <br /> 7. Electricity is provided for my booth's use: 0 Yes X No <br /> 1868 E. Hazelton Avenue ( Stockton, California 952051 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br /> END 1"2 Page 7 of 12 TEMP EVENT APP <br /> 07r4/17 <br />