Laserfiche WebLink
Date(s): <br />1. <br />2. <br />Phone: <br />3. <br />4. <br />5. <br />6. <br />the hot and cold holding of potentially hazardous <br />9. <br />— Oc? IC~ <br />7. <br />8. <br />asphalt, clean tarps and smooth wood <br />areas from the public. <br />Environmental Health Department <br />)_______ <br />ClwJtQM <br />ipproved commercial facilities: Yes O No <br /> Phone: (‘SrFf ) - <br />? v ( CtQ____ ------------------------------------------ <br />rny unpackaged food and food-preparation areas from flies, <br />/Mm I ftmoervcan Fnaea <br />s4-z>cUAwi C<t___9 s P c- - <br /> Alternate: ( <br /> Other (specify):_ ___________ _ - <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 /> Other (specify):.-------—------------- <br />Electricity is provided for my booth’s use^H Yes No <br />I am providing an accurate probe thermometer to measure <br />foods during all times of booth operation: Yes^0 No <br />I am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br />135°F: <br />^fCamp stove Sterno & hotel trays <br />J3"Double steamer ^^Steam table & lids <br />^Electric stove top Other (specify) D&ep Fry <br />Note: Examples of potentially hazardous food include: meats, tamales, cooked beans, rice, <br />vegetables, potato salad, eggs, and dairy products. <br />, SANJOAUUIN <br />' -------COUNTY------- <br />Greatness grows 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 />'y easr 'O'-x.v'd <br />1868 E Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjcehd.com <br />Dans 7nf 11 * bMr tVtlN I ArrEHD 16-02 Page/or 11 <br />07/3/17 <br />the festival coordinator three (3) weeks prior to this event. <br />1. Name of FventS-C- F <br />The following is information about my organization/business. <br />Name of organization/business: Hancjll <br />Address: ,$?I-IUO S. <br />() AUX— --------- <br />List food to be sold or given to the public: &CCe-fy A} CWSe\.!^ <br />I am providing food that is NOT prepared at home: Yes No <br />All food is prepared on-site or is from a[. <br />Name of facility: PA . 4-p r 1 j------------- <br />Address of facility: S Uki <br />I am providing a booth with the following, (to protect r <br />dust and the public) <br />“-SHE- EEE-B