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Environmental Health Department <br />;r- <br />Date(s): <br />2. <br />T <br />Phone: <br />) <br />3. <br />4. <br />5. <br />6. <br />9. <br />meats, tamales, cooked beans, rice, <br />7. <br />8. <br />SAN JOAQUIN <br />------COUNTY------ <br />eojnjfss irerf. <br />TEMPORARY FOOD VENDOR’S APPLICATION <br />All food vendors (both for profit and non-profit) arc <br />the festival coordinator three (3) weeks prior to this <br />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 />Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods: <br /> Approved bottled water. <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 1 F 209 464-0138 | www.sjgov.org/ehd <br />EHD 16-02 Page 7 of 11 TEMP EVENT APP <br />07/01/2024 <br />Q On-site hose bib that is connected to a potable water source. <br />[ETother (specify): <br />Electricity is provided for my booth’s ui: [£p?es No ~ ------ <br />I am providing an accurate probe thermometer to measure the hot and cold holding of potentially hazardous <br />foods during all times of booth operation: Hves No <br />I am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br />135 F: <br />EJ Camp stove Stprno & hotel trays <br /> Double steamer Q'Steam table & lids <br /> Electric stove top Other (specify) <br />Note: Examples of potentially hazardous food include: <br />vegetables, potato salad, eggs, and dairy products. <br />are eventred t0 3 S'9ned and completed copy of this checklist to <br />1-Name of Event: <br />The following is information about my organization/business: <br />Name of organization/business: <br />Address: l4bc( ITfes-fa <br /> Alternate: ( <br />List food to be sold or given to the public: 3^flak <br />I am providing food that is NOT prepared at home: YesJ3l\to <br />All food is Prepared.op-ge or is from..approved pommercial facilities: Yes,0 No <br />Name of facility: d phone; <br />Address of facility:, C/l ^5^0] <br />' th9 3 b£°\h W'th thS follow‘n9: (t0 P'rotect my unpackaged food and food-preparation areas from flies, <br />uUSt atiQ tnG pUDllC) <br />Da booth 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 />srsss from ths public. <br /> Other (specify):_________________________