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Environmental He< !epartn .it <br />TEMPORARY FOOD VENDOR’S APPLICATION <br />f this checklist to <br />St. Bernards Parish Fall Festival1.I.Name of Event:D 3(S <br />2.The following is information about my organization/business: <br />Name of orqanization/business:st. Bernard's Parish Fall Festival <br />Address: <br />607--,209Phone:Alternate: () <br />Pizza3.List food to be sold or given to the public: <br />4. <br />3 <br />5.areas from flic s, <br /> Other (specify): <br />6.Approved water for drinking, utensil and hand washing will be provided in my b >ji'i by t ;ng methods: <br /> Approved bottled water. <br />[3 On-site hose bib that is connected to a potable water source. <br />’tally bazar-'s <br />9.jus foods abc. e <br />■ ’ be used to k--p <br />\ <br />? floor (concre e, <br />food preparal i <br />.v.sjgov.org/eh J <br />TEMP EVENT APR <br />7. <br />8. <br />SAN JOAQUIN <br />COUNTY <br />All food vendors (both for profit and non-profit) are required to return a signed and completed ■ <br />the festival coordinator three (3) weeks prior to this event. <br />[3 A booth with walls and ceiling constructed of either wood, canvas, plastic, similar ma’eri and fine mesh fly <br />screening, completely enclosing open food areas. It will also have a smooth and cl-, <br />asphalt, clean tarps and smooth wood are acceptable) and constructed to separate fo <br />areas from the public. <br />Note: The only operations not required to provide enclosed booths are those wh: ’ i s- beverages from <br />approved dispensers, or prepackaged foods from approved sources. <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 i . <br />EHD 16-02 Page 7 of 11 <br />07/01/2024 <br /> Other (specify): <br />Electricity is provided for my booth’s use: 0 Yes No <br />I am providing an accurate probe thermometer to measure the hot and cold h-Hing <br />foods during all times of booth operation: H Yes B No <br />I am providing the following hot temperature control for the hot holding of all potentially <br />135°F: <br /> Camp stove <br /> Double steamer <br /> Electric stove top <br />I am providing food that is NOT prepared at home: (3 Yes No <br />All food is prepared on-site or is from approved commercial facilities: 0 Yes No <br />Name of facility: st. Bernard's church Phone: ~ <br />Address of facility: 163 w~ Eaton Ave- 'rracy Ca 95376__________________________ <br />I am providing a booth with the following: (to protect my unpackaged food and food-prep: ra' <br />dust and the public) <br />( 209 <br />163 w. Eaton Ave. Tracy Ca 95376 <br />Sept 14th & 35th, 2024 <br />) 835-4560 <br /> Sterno & hotel trays <br /> Steam table & lids <br />(3 Other (specify) pizza n-.mir. <br />pizza hot. <br />Note: Examples of potentially hazardous food include: <br />vegetables, potato salad, eggs, and dairy products. <br />1 beans, i.meats, tarn les,