Laserfiche WebLink
SAWOAQUIN <br /> <br />Environmental Health Department <br />—COUNTY <br />C1,41111:_,1-1 Greatress grows here <br />TEMPORARY FOOD VENDOR'S APPLICATION <br />Date(s): <br />s74_. <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 ev <br />1.Name of Event: <br />The following is information about n2yor anization/businss: <br />Name of organization/business: /k-inft- <br />CA- ,3 <br />Alternate: 0 c) V47-S- <br />wa \nffi <br />I am providing food that is NOT prepared at home:E Yes El No <br />All food is prepared on-site or is from approved commercial facilities: El Yes yl No <br />Name of facility: Phone: ( <br />Address of facility: <br />I 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 booth with walls and ceiling constructed of either wood, canvas, plastic, similar material and fine mesh fly <br />ening, 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 />l Approved bottled water. <br />n-site hose bib that is connected to a potable water source. <br />l Other (specify): <br />Electricity is provided for my booth's use: <br />I am providing an accurate probe thermo e*measure the hot and cold holding of potentially hazardous <br />El Ye No <br />foods during all times of booth operation: Yes I=1 No <br />I am providing the following hot temperate control for the hot holding of all potentially hazardous foods above <br />135°F: <br />LI Camp stove <br />['Double steamer <br />1=I Electric stove top <br />Note: Examples of potentially hazardous food include: meats, tamales, cooked beans, rice, <br />vegetables, potato salad, eggs, and dairy products. <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sjgov.org/ehd <br />EHD 16-02 Page 7 of 11 TEMP EVENT APP <br />06/29/2023 <br />3. List food to be sold or given to the public: <br />Address: <br />Phone: (,.20° ) —ocas-7, <br />1 S erno & hotel trays <br />Steam table & lids <br />111 Other (specify)