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Of thi'-i ctiecWfet to <br />(both for profit and non-prof ’) <br />1. <br />2 <br />Address:) Alternate: ( <br />3. <br />4. <br />5. <br />v/fiich sett beverages from <br />6. <br />9. <br />meats, tamales, cooked beans, rice <br />vegetables, potato salad, eggs, and dairy products. <br />7. <br /> Other (specify):------------------- <br />Note: The only operations not <br />approves dispensers, < , <br />Approved water for drinking, utensil ai <br />Lj Approved bottled water. <br /> On-site hose bib that is connected to a potable water source. <br />1868 E Hazelton Avenue | Stockton. California 95205 | T 209 46B-3420 | F 209 464-0138 | www.sjgov.org/eh <br />EHD Pa9'J 7 0< 11 TEMP EVENT <br />. plastic, similar material and(fine mej.fly <br />•ave a smooth and cleanable floor (concreU <br />.tructed to separate food and food preparauon <br />All food vendors <br />the feslivu. — <br /> I.Namo of Event: wrry t <br />Tnc following io Informalion about my organlzatton/buslness: <br />Name of organlzatlon/buslness: ' <br />CFi^/L£A_jag£ <br /> <br />Phone: (2^ ) <br />List food to be sold or given to the public: <br />,.„t required to provide enclosed booths are those <br />or prepackaged foods from approved sources. <br />nd hand washing will be provided in my booth by the following methods: <br />Environmental tieaim <br />I am providing food that is NOT prepared at home: H'Yes No <br />All food is prepared on-site or is from approved commercal faclto. □ <br />r I I'J i • tz. y . » ’ ~ ' <br />Name of facility. ---------------- ------------------------------- -- ------------------------------------------- <br /> Address of facility:_------------------ -------------------^77r^oackaaed food and food-preparation areas from fl>es. <br />I am providing a booth with the following: (to protect my unpa.. g <br />dust and the public) <br /> A booth with walls and ceiling constructed of either wood canvas. <br />= SSill... <br />areas from the public. <br /> Other (specify): -----------------------------—e-, -------------------------------- <br />rX^idin^an a— —el" to measure the hot and cold bolding of potently hazardous <br />! Crowding ^fX^X"e coXi for the hot holding of alt potentially hazardous foods above <br /> Camp stove Stemo & hotel trays <br />Double steamer O Steam table & lids <br /> Electric stove top O Other (specify) <br />Note: Examples of potentially hazardous food include. <br />SAN JOAOUI' <br />--COUNTY-- <br />' ' " tEMPORARY FOOO VENDOR'S APPLICATION <br />,««»-p« •« -r “‘ ■""I ■“ ‘"p“ <br />,.,1 coordinator three (3) weeks prior to this ovcm . It [