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R EC-008 <br /> S A N O A Q U I N Environmental Health Department <br /> COUNTY-- <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. <br /> I. 1.Name of Event: Music in the Date(s): 9-21-24 <br /> 2. The following is information about my organ izatioNbusiness: <br /> Name of organization/bu�siiness'. O a_o 4l)PYu!— <br /> Address: t 8 9,11 "t'.dA.L- <br /> Phone: ()_ �'1t t> ' ��C�i Alternate: <br /> 3. List food to be sold or given to the public: _Lernc y- m, <br /> 4. 1 am providing food that is NOT prepared at home.fqes 0 <br /> All food is prepared on-site or is from approved commercial facilities.f aes[]No <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 /> booth with walls and ceiling constructed of either wood, canvas, plastic, similar material and fine mesh fly <br /> sc eening, completely enclosing open food areas. 11 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 /> 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 /> aApproved bottled water. <br /> Dn-site hose bib that is connected to a potable water source. <br /> 7. Pher(specify): <br /> ectricily is provided for my booth's use Ye jC No <br /> B. I am providing an accurate probe the r 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 temperatu contr i o the hot holding of all potentially hazardous foods above <br /> 5°F: <br /> amp stove Stemo& hotel trays <br /> ouble steamer Steam table&lids <br /> lectric stove top Other(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 952051 T 209 468-34201 1F 209 464-0138 1 www.sigov.org/ehd <br /> EHD 16.62 Page 7 of 11 TEMP EVENT APP <br /> asrl�ts <br />