Laserfiche WebLink
SAN JOAQUIN Health Department <br />Environmental <br />i <br />Date(s) <br />2 <br />Address <br />Phone ) ( <br />3 <br />4 <br />5 <br />I <br />6 <br />the hot and cold holding of potentially hazardous <br />9 <br />■Mr- jr. <br />7 <br />8 <br />135T: <br /> Camp stove <br />Q Double steamer <br /> Electric stove top <br />F 209 464-0138 ( www sjgov org/ehd <br />TEMP EVFNT APR <br />meats, tamales, cooked beans, rice, <br />All food v?_ <br />the festival <br />return a signe!:t 3 <br />f Ha2e,ton Avenue | Stockton California 95205 | T 209 468-3420 | <br />07101'2026 Page 7 of 11 <br />0 Yes No <br />Phone [1 <br />TEMP0RW, fooo vendors application <br />' ax™ ~ sx*-•«™»•-* ™ ” <br />> wMt.fcr .....x|i«J2!e_ <br />ame of organ,zat,on/buslness: tyj <br />AVf tod. CA <br />( .^1)5212^^-) Alierna® <br />List food l0 be sold or g|ven fo (he pubhc <br />' am providing food that ,s not prepared at home 0 Yes No <br />> 000 IS prepared on-site or js from approved commercial facilit'®5 <br />Name of facility <br />Address of facility <br />' and 'ood'prepara'lon areas ,rom flies <br />asphalt clean tarps and smoS Xd acceptable) and constructed to separate food and food preparation <br />areas from the public <br />□ Other (specify) _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 />Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods <br /> Approved bottled water <br /> On-site hose bib that is connected to a potable water source <br />E3 Other (specify) > Jh1^ --------- <br />Electricity is provided for my booth's use '0 Yes No <br />I am providing an accurate probe thermometer to measure <br />foods during all times of booth operation. 0] Yes No <br />I am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br /> Sterno & hotel trays <br /> Steam table & lids <br />H Other (specify) <br />Note: Examples of potentially hazardous food include: <br />vegetables, potato salad, eggs, and dairy products.