Laserfiche WebLink
1 <br /> S A N J OA Q U I N Environmental Health Department <br /> COUNTY <br /> i <br /> TEMPORARY FOOD VENDOR'S APPLICATION <br /> I <br /> All food vendors (both for profit and non-profit)are required to return a signed and completed copy of this checklist to i <br /> the festival coordinator three(3)weeks prior to this event, l <br /> 1. 1.Name of Event: C1CK Z� Date(s): �G 7 <br /> 2. The following is information about my organization/business: <br /> Name of organizationlbusiness: r b>,S qo d L Le, <br /> Address: <br /> Phone: (Z�- ) v�I 1j��� 11 TT Alternate: ( ) � � <br /> 3. List food to be sold or given to the public: br �Xs <br /> 4. 1 am providing food that is NOT prepared at home: P Yes❑No <br /> All food is prepared ite or Is from approved commercial facilities_ 21yes ❑ No <br /> Name of facility: t Q 1 Phone:Ly�� <br /> Address of facility: I J s illya pr o <br /> 5. 1 am providing a booth with the following: (to protect my unpackaged food and food-preparation areas from flies, <br /> dust and the public) <br /> [a A booth with walls and ceiling 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 /> ❑ 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 methods: <br /> ❑Approved bottled water. <br /> ❑ On-site hose bib that is connected to a potable water source. <br /> U//O i'Tther(specify): rills W;sh(K Qnt,�, <br /> 7. Electricity is provided for my booth's us . E214es❑No <br /> 8. 1 am providing an accurate probe thermomet to measure the hot and cold holding of potentially hazardous <br /> foods during all times of booth operation: UYes ❑ No <br /> 9. 1 am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br /> 135°F: <br /> ❑camp stove ❑Sterna&hotel trays <br /> ❑Double steamer team table&lids <br /> ❑Electric stove top ❑Other(speclfy) <br /> Note: Examples of potentially hazardous food include: meats, tamales, cooked beans, rice, <br /> vegetables,potato salad, eggs,and dairy products. <br /> 1868 E. Hazalton Avenue I Stockton, California 95205 1 T 209 468-3420 � F 209 464-0138 1 www.sjgov.org/ehd <br /> EHO 10-02 Page 7 of 11 TEMP EVENT APP <br /> UB12Y12U23 <br />