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Environmental Health Department <br />7 of 11 <br />1 <br />2. <br />r <gSsy. <br />4 <br />s <br />w*w fcx drsrfang, utensil and hand washing win be provided in my booth by the following methods'e <br />Q Aoprwed boSed w^er <br /> Ofwfc hose Wb SMit «s connected to a potabte water source. <br />& <br />meats, tsmales, cooked beans, rtea. <br />ttUPtVIW *FF <br />7 <br />8 <br />O Orw («c«c»!yt ______________________________________ _——--------------------- ------------- ----------------- <br />Mota: The onty operaborw not requred to provide enclosed booths are those which sell beverages from <br />approved drspemers. or prepackaged foods from approved sources. <br />O Ow tspeaM __ _______________ _____________________________________ _—-------------- <br />EJecroty » provided tor my booth's use Q Yes Q No <br />I aw prw»dng an asxurata probe thermometer to measure the hot and cold holding of potentially hazardous <br />SANJOAOUIN <br />OUNTV- <br />? t % • • «r i <* <t <br />TEMPORARY FOOD VENDOR’S APPLICATION <br /> A tx»«h wSh wafc and aHkng constructed of either wood, canvas, plastic, similar material and fine mesh fly <br />aa-aanng. ctrnpiewly anckMang open food areas. Il will also hove a smooth and cleanable floor (concrete. <br />BaMt clean tarps and smooth wood are acceptable) and constructed to separate food and food preparation <br />wws trew Sw pubhc <br />Ncaat Baampia* &t hscardoua food Include: <br />vagnstoMe*. poMo salad, eggs, and dairy product*. <br />1W£ HMsfcnAwrwl StocAton. CaMorrua »$K5 | T 209 4OT-M20I F 209 464 0138 | www »jgov orgzehfl <br />smc rwj* twlii teeth A! <br />taodd dumg «• femes of boodt operation: Q Yes No <br />I am yowling the Wtawrtg hot temperature control for the hot holding of all potentially hazardous foods above <br />13$ F <br /> Camp O Stem© & hotel trays <br />O ttoub* staanw Steam taWe & Ids <br /> Beane stow top Otfw (specify) <br />Al tood vendors (both tor profit and non-profit) are required to return a signed and completed copy of this checklist to <br />toe toatwal coordnatw throe (3) weeks prior Io this event ^fcVtatrcf <br />t.Name of Evert Dato(s) /you 2^ <br />Sovy^CUfj '2- <br />The tofeoewng ts eWetMtoi about my organuaBonlbuslnos* J <br />Name of (YYl-l to4 SAiHmqh__________ <br />Hid v-m-u-p ft mcr(e4to..c.fe_y£3£?> <br />3^^-^35 Alternate ( ) _ <br />IM fexrf to be ac4d or gMsn to the public: i j a .u.j h r’xea d <br />I am provtorig tood toat« NOT prepared at home. O Vos ®-No <br />AS toed « preperod owato or » from approved commercial facilities: Q Vos LJ No <br />Name of factory Phono ( ) <br />Adtoeea of toctoty............................................................................. ......... <br />I twn prwtobng a boom w«h th* toaewng. (to protect my unpackaged food and food-preparation areas from flies, <br />eked amd toe putAc)