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R EC-008 <br /> SAN.- JOAQUIN Environmental Health Department <br /> -d —CouNTY <br /> TEMPORARY FOOD VENDOR'S APPLICATION <br /> AD food vendors (both for profit and non-profii) are required to return a signed and completed copy of this checidisi to <br /> the festival coordinator three(3)weeks prior to this event. <br /> Kite Festiv Ej ?� uSi N (I/"- s): t7-y -.2 <br /> 1. 1.Name of Event: t�tG ��� yt w ' 6,-)��.c/ <br /> 7 _1G. 2y <br /> 2. The following is information about my organization/business: g- ' -7-l}6 <br /> Name of organizationlbusiness: ' / '� ZZ k,' A2 C <br /> Address: /3 5-8 1141/L4SS0 c.— ))/zI've— '7-c �5 37 <br /> Phone: a Alternate: `;- /2 <br /> 3. List food lobe sold or given to the public: <br /> 4. 1 am providing food that is NOT prepared at home:5r'esDo <br /> All food is prepared on-sile or is from approved rnereial facilities0yescAlo <br /> Name of facility: /� /1 —Phone-- <br /> Address of facility: <br /> 5. 1 am providing a boolh with the following:(to protect my unpackaged food and lood-preparalion areas from flies, <br /> dust and the public) <br /> booth with walls and ceiling constructed of either wood, canvas, plastic, similar material and fine mesh fly <br /> VMening, completely enclosing open food areas. It will also have a smooth and cleanable floor (concrete, <br /> asphalt, dean tarps and smooth wood are acceptable) and constructed to separate food and food preparation <br /> (areas,from the public. <br /> E]Dther(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 /> Din-site hose bibthat is connected 10 a potable water source. <br /> 7. QXher(specify): <br /> vicity is provided for my booth's use Ye No <br /> B. 1 am providing an accurate probe the asure the hot and cold holding of potentially hazardous <br /> foods during all times of booth operation Ye o <br /> 9. 1 am providing the following hot iernperatu ntr the hot holding of all potentially hazardous foods above <br /> 5 F: <br /> amp stove Sterno& hotel trays <br /> ouble steamer team table &lids //� <br /> lectric stove lop her(specify) iv( <br /> Note: Examples of potentially hazardous food Include: meals, tamales, cooked beans, rice, <br /> vegetables,potato salad,eggs,and dairy products. <br /> I <br /> 1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-3420 i F 209 464-0138 [ www.sjgov.rrg,'chd <br /> EM M02 Page 7 d 11 Trv.p rvENT APP 1 <br /> 06'19'19 <br /> � i <br />