Laserfiche WebLink
Environmental Health Department <br />All food vendors (both for profit and non-profit) <br />1. <br />2. <br />Address: <br />Phone: <br />3. <br />4. <br />5. <br />which sell beverages from <br />6. <br />9. <br />meats, tamales, cooked beans, rice, <br />7. <br />8. <br />pier to measure the hot and cold holding of potentially hazardous <br />hot holding of all potentially hazardous foods above <br />209 464-0138 | v^w.sjcehd.com1868 E. Hazelton Avenue | Stockton, California 9520^ 7,209 468-3420 | F <br />EHD 16-02 <br />07/3/17 <br />• required to provide enclosed booths are those <br />prepackaged foods from approved sources. <br />SAN JOAOUIN <br /> COUNTY------ <br />Greatness grows here. <br />TEMPORARY FOOD VENDOR’S APPLICATION <br />-) 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. ------------------------------Date<s>: - <br />The following is information about my organization/business: <br /> <br />Name of organization/business: <br />pl 1 J-------- <br /> <br /> Alternate:( ’------------ <br /> List food to be sold or given to the public: C( frVCO --------------——— <br />I am providing food that is NOT prepared at home: $ Yes No <br />AH food is prepared on-sito or is from <br />Name of facility: TaC \ j > r <br />dust and the public) <br />tn A boosi A'" walls and ceiling eonsUuofecatmoMh^nd ete^able doo, (conerste, <br />areas from the public. <br /> Other (specify);------------------- <br />Note: The only operations not <br />approved dispensers, or | <br />Approved water for drinking, utensil am <br />j | Approved bottled water. <br />)£j On-site hose bib that is connected to a potable water source. <br />BeSric^ for my booth’s use: j>d Yes □ No <br />Fa "ding an accurate probe therm^ter to measi <br /> □s«noa>»ei«.,. <br /> Double steamer O Steam table & lids <br /> Electric stove top other (SP60^)' <br />Note- Examples of potentially hazardous food include: <br />vegSables, potato salad, eggs, and dairy products.