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c <br /> R EC-008 <br /> ;' I, S A N ` J O A Q U f N Environmental Health Department <br /> --•-COUNTY-- <br /> U rw"N., GMIt"055 crows here. I <br /> f <br /> TEMPORARY FOOD VENDOR'S APPLICATION <br /> f <br /> All food vendors (both for profit and non-prolit) are required to return a signed and completed copy of this checklist to <br /> the festival coordinator three(3) weeksrlor to this event. <br /> 1. 1.Name of Event: Music in th - <br /> 2. The following is information about my organ!zationlbusiness: <br /> Name of organ!zatlon/business: Heavenly Ice <br /> Address. 17562 Capricorn Ct, Lathrop, CA 95330 i <br /> Phone: 206-853-3873 Alternate: 925-339-4459 <br /> 3. List food to be sold or given to the public: Italian Ice <br /> 4. 1 am providing food that is NOT prepared at home.w6sDlo <br /> All food Is prepared on-site or is from approved commercial lacilitles:11S.[J a <br /> Name of facility: Stockton Community Kitchen phone. 209-608-5455 <br /> Address of facility:110 N El Dorado St, Stockton, CA (2 ? � S Q c) j <br /> 5. 1 am providing a booth with the following:(to protect my unpackaged food and food-preparatid areas from flies, <br /> dust and the public) <br /> 1 <br /> booth with walls and ceiling constructed of either wood, canvas, plastic, similar material and line mesh fly <br /> s ening, completely enclosing open lood areas. It will also have a smooth and cleanable floor (concrete, <br /> asphalt, clean carps and smooth wood are acceptable) and constructed to separate food and food preparation <br /> areas from the public. <br /> E]Dther(specify): I <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 /> I <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 /> �� i <br /> 7R Jn-site hose bib that is connected to a potable water source.Cher(specify): <br /> 7. Perjrloily is provided for my booth's usef*kAYel I No <br /> B. I 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 temperatu contro o the hot holding of all potentially hazardous foods above <br /> 'f5"F: � <br /> ramp stove Sterna& hotel trays <br /> 3 o�fble steamer Steam table&lids <br /> fectric 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. llazellon Avenue I Stockton,California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/ehd <br /> EHD 1&a2 Page 7 of 11 T[fAP EVENT APP � <br /> p6/19119 <br />