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r1LC; t)oi� I <br /> Envirofltnental Health Department I <br /> COUN <br /> {'9r1rr,�,i�ti Greol'noss yrO Ys hero. <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 chocldist to � <br /> the festival coordinator three(3) weeks prior to lhls event. <br /> 1. 1.Name of Event: Music in thneteenth Fourth of July Mlp July pale{,. 6-15-24 <br /> 7-4-24 <br /> 2. The following Is Informallon about my organ Izallon/businoss: 7-20-24 <br /> Neale of organlzallonlbusiness: Heavenly Ice <br /> Address: 17562 Capricorn Ct, Lathrop, CA 95330 <br /> 206-863-3873 Alt : 925-339-4459 <br /> Phone: ernate I <br /> 3. List food to be sold or given to the public: Italian Ice <br /> I <br /> 4. 1 am provldfng food that is i�OT prepared at home.600 <br /> All tool Is prepared on-site or Is from approved commerolal faclllllas: Yes�Vo <br /> Name of faoility: Stockton Community Kitchen phone: 209-608-5456 i <br /> Address of laolfityl 10 N FI Dorado St, Stockton, CA <br /> 5. 1 am providing a booth with the following:(to protect my unpaokagad load and food-preparation areas from flies, <br /> dust and the public) <br /> k9booth with walls and ceiling constructed of ellher wood, canvas, plastio, similar material and fine mesh fly <br /> enIng, completely enclosing open loud areas. it will also have a smooth and cleanable floor (oonorele, <br /> asphall, clean tarps and smooth wood are acceplablu) and constructed to separate food and food preparation <br /> areas from the public. <br /> Dther(specify): <br /> Nole: The only operallons not required to provide enclosed booths are chose which sell beverages from <br /> approved dispensers, or prepackaged foods from approved sources. <br /> 6. Approved water for drinking, ulansll and hand washing will be provided In my booth by the following methods: I <br /> Approved bottlod water. I <br /> n site hoso bib that Is connected to a potable water source. <br /> Uiiher(speoify): <br /> 7. richy Is provided for my beech's uste '� <br /> No <br /> 0. 1 am providing an accurate probe ther asure the hot and cold holding of potontially hazardous <br /> loads during ail limos of booth operae o <br /> 9. 1 am providing the followlrlp hot tempcntr the hot holding of all potentially hazardous foods above } <br /> .amp stove Slerno,& hotel trays <br /> 13 cable stearner Steam table&Ilds <br /> leolrlo stove top Other(speolty) <br /> Note: Examples of poientlally haxardoug food Include: meats, tamales, cooked beans, rice, <br /> vegetables,polal a sulad,eggs,and dalry products. <br /> f806 E.Hazellon Avenue I Slockton,California 952051 T 209 468.3420 1 F 209 464.0138 1 www,sjgov.org/ehd <br /> No 16•0? PA0070f iS VAAP EVGNTAPP <br /> ual�stss <br /> 1 <br />