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Environmental Health Department <br />1.Date(s): <br />2. <br />Address: <br />Phone: <br />3. <br />4. <br />5. <br /> Other (specify): <br />6. <br />9. <br />meats, tamales, cooked beans, rice, <br />7. <br />8. <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 />[zfApproved bottled water. <br />10’On-site hose bib that is connected to a potable water source. <br /> Sterno & hotel trays <br />0 Steam table & lids <br /> Other (specify) <br />SANJOAQUIN <br />------COUNTY------ <br />Greatness grows here. <br />TEMPORARY FOOD VENDOR'S APPLICATION <br />Note: Examples of potentially hazardous food include: <br />vegetables, potato salad, eggs, and dairy products. <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 />1P5°F: <br />J/fCamp stove <br /> Double steamer <br /> Electric stove top <br />^>-5 /u£4 <br />_____ /XM <br />•□Yes No <br />//M ___________________Phone: <br />at clrirwlo , ShZk/tm <br /> Other (specify):_____________________ <br />Electricity is provided for my booth’s use: Yes No <br />I am providing an accurate probe thermometer to measure the hot and cold holding of potentially hazardous <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />EHD 16-02 Page 7 of 11 TEMP EVENT APP <br />07/01/2025 <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: <br />The following is information about my organization/business: / <br />Name of organization/business: <br />erf tfStyo <br />) 3^0 Alternate: (6)) ^/5 J' <br />List food to be sold or given to the public:t MO.#/b#//- . <br />I am providing food that is NOT prepared at home: 0Yes No <br />All food is prepared on-site or is from approved commercial facilities: <br />Name of facility: ____________Phone. (2^7) 7^/ 5 <br />Address of facility: (fQdS , <3Ifjclv'/trK)____CHI ______ <br />I am providing a booth witn 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, clean tarps and smooth wood are acceptable) and constructed to separate food and food preparation <br />areas from the public.