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y. ;., SQN0lQU I N Environmental Health Department COUNTY— Grectin'ss grows i5cre. TEMPORARY FOOD VENDOR'S APPLICATION Alf food vendors(both for profit and non-profit)are required to return a signed and completed copy of this checklist to the festival coordinator three(3)weeks prior to this event. 1. 1.Nameof Event: Lodi Street Faire Date(s): 05/04/2025 2. The following is information about my organization/business: Name of organization/business: Lodi Police PARTNERS Foundation Address: 215 W. Elm Street, Lodi CA 95240 Phone: ( 209) 333-6886 Alternate:( ) 3. List food to be sold orgiven to the public: Philly Cheese Steak Sandwiches, Chips, & Cotton Candy 4. 1 am providing food that is NOT prepared at home: i3 Yes❑No All food is prepared on-site or is from approved commercial facilities: ®Yes❑No Name of facility. Phone:{ ] Address of facility- 5- 1 am providing a booth with the following:(to protect my unpackaged food and food-preparation areas from flies, dust and the public) A A booth with walls and ceiling constructed of either wood, canvas,plastic,similar material and fine mesh fly screening, completely enclosing open food areas. It will also have a smooth and cleanable floor (concrete, asphalt, clean tarps and smooth wood are acceptable)and constructed to separate food and food preparation areas from the public. ❑Other(specify): Note: The only operations not required to provide enclosed booths are those which sell beverages from approved dispensers,or prepackaged foods from approved sources. & Approved water for drinking,utensil and hand washing will be provided in my booth by the following methods: [N Approved bottled water. ❑On-site hose bib that is connected to a potable water source. ❑Other(specify): 7. Electricity is provided for my booth's use:iKI Yes❑No 8_ 1 am providing an accurate probe thermometer to measure the hot and cold holding of potentially hazardous foods during a[I times of booth operation.®Yes[I No 9. 1 am providing the following hot temperature control for the hot holding of all potentially hazardous foods above 135'F: ❑Camp stove ❑Stemo&hotel trays ❑Double steamer ❑Steam table&lids ❑Electric stove top 2S]Other(specify) Insulated Food Carrier Boxes Note: Examples of potentially hazardous food include: meats, tamales, cooked beans, rice, vegetables,potato salad,eggs,and dairy products. 1868 E_ Hazelton Avenue l Stockton,California 952051 T 209 468-3420 l F 209 464-0138 1 www.sjcehd.com EM 1"2 Pago 7 of 11 TEMP EVENT APP 07l3197