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SAN J OAQ U I N Environmental Health Department COUNT'Y - �o CO" -a %% 4 �),sI hr-r TEMPORARY FOOD VENDOR'S APPLICATION A4 food vendors(tooth for profit and non-profit)are required to return a signed and completed copy of this checklist to the festival 000rdinator three(3)weeks prior to this event. 1, 1.Name of Event Manteca Autism and Resource Spring Festival Date(s):_ 04/12/2025 ?n The following is Information about my organization/business: Name of organizationlbusiness: Address: s Phone: ( zos ) Alternate; ( } 3. List food to be sold or given to the public LQmoradesI 4. 1 am providing food that is NOT prepared at home:U Yes❑No 1 All food is prepared on-site or Is from approved commercial facilities:U Yes❑ No Name of facility Y Phone:QG 11 )c-1g 1, V I S' Address of facility. 7 , 5. 1 am providing a booth with the following: (to protect my unpaclkaged food and food-preparation areas from flies, dust and the public) ®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" dean tarps and smooth wood are acceptable) and constructed to separate food and food preparation areas from the public. ❑Other(spay): Note: The only operations not required to provide enclosed booths are those which sell beverages from approved dispensers, or prepackaged foods from approved sources. 6. Approved water for drinking,utensll and hand washing will be provided in my booth by the following methods: ®Approved bottled water. ❑On-she hose bib that Is connected to a potable water source. ❑Other(specify): 7. Electrk;fty Is provided for my booth's use: Yes No 8. 1 am providing an accurate probe thermometer to measure the hot and cold holding.of potentially hazardous foods during all times of booth Operation: ®Yes❑ 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 eteamer ❑ Steam table&lids ❑Elec W stove trap ❑Other(specify) Note: Examples of potentially hazardous food Include: meats, tamales, cooked beans, rice, vegetables,potato salad, eggs, and dairy products. 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sigov.org/ehd END 1&02 P.ge 7 of 11 TemP EVENT APP 07ro1MU