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Environmental Health Department <br />2. <br />)_3. <br />4. <br />5. <br />6. <br />9. <br />meats, tamales, cooked beans, rice, <br />7. <br />8.the hot and cold holding of potentially hazardous <br />providing the following hot temperaturTtontrol for the hot holding of all potentially hazardous foods above <br /> Sterno & hotel trays <br /> Steam table & lids <br />O Other (specify) E . <br />Note: Examples of potentially hazardous food include: <br />vegetables, potato salad, eggs, and dairy products. <br /> Other (specify): <br />Electricity is provided for my booth's use: Yes No <br />I am providing an accurate probe thermometer to measure <br />foods during all times of booth operation: E Yes No <br />135°F: <br /> Camp stove <br /> Double steamer <br />Electric stove top <br />a signed and completed copy of this checklist to <br />•Atf <br />-----------—------------- - Date(s): 6 <br />All food vendors (both for profit and non-profit) are <br />the fest/val coordmator three (3) weeks prior to this <br />1. <br />MN JOAQUIN <br />COUNTY-... <br />TEMPORARY FOOD VENDOR’S APPLICATION <br />vendors (both for profit and non-profit) are required to return <br />. . .. ..s event. <br />1. Name of Event: 1 <br />The following is information about my organization/business: <br />Name of organization/business: INl ■ <br /> <br /> rtddreSS: Cfr Cf Qj ! <br /> <br />Phone: ( Tfpf ________________Altemate: { <br />List food to be sold or given td the public: Tm> Uhp <br />I am providing food that is NOT prepared at home: Yes No <br />AH food is prepared on-site or is from approved commercia! faculties: B Yes H No <br />Name of facility:Cl Uh <br /> Address of (Z' ------------ <br />Lj-A booth with walls and ceiling constructed of either wood canvas nlastir - - <br />.» wi" have’a smooth <br />areas from the public. <br /> Other (specify): <br />th°Se WhiCh Se“ b6vera9es from <br />Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods: <br />^Approved bottled water. <br /> On-site hose bib that is connected to a potable water source. <br />^8 E Hazelton Avenue | Stockton. California 95205 | T 209 468-3420 1 F 209 464-0138 | www.sjgov.org/ehd <br />07/01/2024 Page 7 o,11 TEMP EVENT APP