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Environmental Health Department <br />1, <br />2. <br />3. <br />4. <br />5. <br />6. <br />9. <br />meats, tamales, cooked beans, rice, <br />i <br />i <br />7. <br />8. <br />Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods: <br />QjXpproved bottled water. <br />SAN JOAQUIN <br />------C OUNTY------ <br />Crfhng co c f <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 /> On-site hose bib that is connected to a potable water source. <br />Ej73ther (specify): <br />Electricity is provided for my booth’s use: Q^es No <br />I am providing an accurate probe thermometerto measure the hot and cold holding of potentially hazardous <br />foods during all times of booth operation: ©Yes No <br />I am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br />tSST: z <br /> Camp stove 0Sterno & hotel trays <br /> Double steamer Q Steam table & lids <br /> Electric stove top [3Other (specify) cJi/l <br />Note: Examples of potentially hazardous food include: <br />vegetables, potato salad, eggs, and dairy products. <br />1868 E. Hazelton Avenue | Stockton. California 95205 | T 209 468-3420 1 F 209 464-0138 | ww sjgav^ehd^ <br />EHD 16-02 Pago 7 oM ' <br />07/01/2024 <br />TEMPORARY FOOD VENDOR’S APPLICATION <br />the festival coord.nX thre^S) weeks pdo? to this 3 comptoted W of checkfrst to <br />1 Name o' Even‘ —/) y Dale(s) ///g <br />The following is information about my organjzatiorVbusiness; <br />Name of organization/business: /> O <br /> Address: ^37^ C/) (/JL <br />Phone. Alternate. ( <br />List food to be sold or given to the public: 2 fyvfi?/-J <br />I am providing food that is NOT prepared at home: □'Yes No <br />All food is prepared o^-sne or is from approved commercial facilities- LJ'Yes No <br />Name of facility: A 6? z? W/ 7}/^^ Phone: (2^) 3 £ 5 <br />Address of facility:/3 S/- a4 J~2-XZ <br />I arn providing a booth with the following: (to protect my unpackaged food and food-preparation areas from flies <br />dust and the public) <br />O A 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 />areas from the public. <br />[3 Other (specify): 3