Laserfiche WebLink
f <br />■J. <br />1. <br />2. <br />Phone: <br />3.1 4 <br />4. <br />1 <br />5. <br /> Other (specify): <br />meats, tamales, cooked beans, rice, <br />'-M <br />Note: Examples of potentially hazardous food include: <br />vegetables, potato salad, eggs, and dairy products. <br /> Stemo & hotel frays <br />Q^Steam table & lids <br /> Other (specify) <br />6. <br />r <br />Alternate: ( <br />UMn'JUMWVIH --------........... <br />. -—COUNTY— <br />G.-ecifness aroivs here. <br />TEMPORARY FOOD VENDOR’S APPLICATION <br />All food vendors (both for profit and non-profit) are required to return a signed and completed copy of this checklist to <br />the festival coordinator three (3) weeks prior to this event. <br />1 .Name of Event: iSL&lM&S CJFM <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 />Approy^d water for drinking, utensil and hand washing will be provided in my booth by the following methods: <br />The following is information about my organization/business: <br />L1 -n <br />1868 E Hazelton Avenue | Stockton, California 95205 | T 209 468-3420} F 209 464-0138 | www.sjgov.org/ehd <br />EHD16X)2 Page 7 of 11 TEMP EVENT APP <br />06/29/2023 <br />□'Approved bottled water. <br />. v <br /> Oh-stte hose bib that is connected to a potable water source. <br />7. <br />8. <br /> Other (specify):_ _:——--------------------------- <br />Electricity is provided for my booth’s use: Yes Q 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: O Yes No <br />I am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br />0Camp stove <br />0wuble steamer <br /> Electric stove top <br />I <br />I am providing food that is NOT prepared at home: O Yes Q No <br />All food is prepared on-site or is from approved commercial facilities^E^Yes No <br />Name of facility: Phone: (___ <br />Address of facility: '_____________________________ <br />I am providing a booth with the following: (to protect my unpackaged food and food-preparation areas from flies, <br />dust and the public) <br />[^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, dean tarps and smooth wood are acceptable) and constructed to separate food and food preparation <br />areas from the public. <br />Date(s): 4/g?- <br />Name of organization/business: <br />Address: '2S H w <br />List food to be sold or given to the public:__F <br />) <br />/ _______________