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jalth DepartmentEnvironmenta <br />I Date(s): <br />2. <br /> <br /> <br />Address. <br />3. <br />4. <br />5. <br /> <br />6. <br /> <br />9. <br />meats, tamales, cooked beans, rice, <br />T <br />unpackaged food and food-preparation areas from flies, <br />TEMPORARY <br />All food vendors (both tor profit and non-profit) are required to return a signed <br />the festival coordinator three (3) weeks prior to this event. <br />I. <br />SAN JOAQU,. <br />cot I NT Y <br />1. Name of Event:f A-Z <br />The following is information about my organization/business: <br />Name of organization/business . <br />( Alternate: ( )-------- <br />U? fr V t/^ ----- <br />t required to provide enclosed booths are those which sell beverages from <br />o“r prepackaged foods from approved sources. <br />,d hand washing will be provided In my booth by the following methods: <br />FOOD VENDOR’S APPLICATION <br />and completed copy of this checklist to <br />Phone: ( <br /> <br />List food to be sold or given to the public: <br />I am providing food that is NOT prepared at home: ]3^es □ No <br />All food is prepared on-site or is from approved commercial facilities: O Yes <br />,. .... Phone: (___ JName of facility: -------------------------- --------------------- ----------------- <br /> Address of facility:_ <br />I am providing a booth with the following: (to protect my <br />dust and the public) <br />booth with walls and ceiling constructed of either wood =a^s, deanable floor (concrete, <br />screening, completely enclosing open food areas, t w'" als° [0 arale (ood and food preparation <br />asphalt, clean tarps and smooth wood are acceptable) and constructeo p <br />areas from the public. <br />209 464-0138 | <br /> Other (specify):----------------- <br />Note: The only operations not <br />approved dispensers. < . <br />Approved water for drinking, utensil ah' <br />^Q^pproved bottled water. <br /> On-site hose bib that is connected to a potable water souice. <br /> Double steamer 0 Steam table & hds <br /> Electric stove top Other (specify) <br />a I Stockton California 95205 | T 209 468-3420 | F <br />1868 E. Hazelton Avenue | Stockton, van 7o( n <br />EHD 16 0? <br />C7/3/17