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R EC-008 <br /> S A N J O A Q N I N Environmental Health Department <br /> —CU NTY <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 to <br /> the festival coordinator three(3) weeks prior to this event. tt <br /> 9. I.Name of Event: Music in the Date(s): 2 <br /> 2. The following is information about my organ ization/b�usine�ss:, <br /> Name of organization/business: <br /> Address: L'� :l �j L �S­q tL AA H(:i F_ Cc4 <br /> Phone: � � TA 4 2_e� Alternate: <br /> 3. List food to be sold or given to the public: 1 (�. (•� � _. L.� SrC.'7 <br /> 4. 1 am providing food That is NOT prepared at home: esDo <br /> All food is prepared on-site or is from approved commercial facilities:EYZk <br /> Name of facility: Phone: <br /> Address of facility: <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 /> Dbooth 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 /> � ther(specify):_ti � , 1— <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 /> rn- 'le hose bib that is connected to a potable water source. <br /> Cher(specify): <br /> 7. eciricity is provided for my booth's use e No <br /> S. I am providing an accurate probe the i 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 temperature con1m or the hot holding of all potentially hazardous foods above <br /> 5°F: <br /> amp stove S rno&hotel trays <br /> ouble steamer rher <br /> table &lids <br /> lectric stove top (specify) <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 ( www.sjgov.org'ehd <br /> EHD 16-02 Page 7 of 11 TEMP EVENT APP <br /> 06119/,19 <br /> I <br /> I <br />