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1. <br />2. <br />6(TA <br />3. <br />4. <br />5. <br />which sell beverages from <br />required to provide enclosed <br />6. <br />9. <br />meats, tamales, cooked beans, rice.Note: <br />7. <br />8. <br />ipy of this checklist to <br />Date(s): Jri------- ------------ <br /> Other (specify): ----------------------------------------------------------------------------- <br />Note- The only operations not required to provide enclosed tooths are those <br />approved dispensers, or prepackaged foods from approved sources. <br />Approved water for drinking, utensil end hand washing will be provided in my booth by the following methods: <br />PtyApproved bottled water. <br /> On-site hose bib that is connected to a potable water source. <br />■r ■°C.' <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 1 F 209 464-0138 I www.sjcehd.com <br />EHD 16-02 Page 7 of 11 TEMP EVENT APP <br />A-7/OH 7 <br />Environmental Health Department <br />MPORARY FOOD VENDOR'S APPLICATION <br />required to return a signed and completed co. <br /> Other (specify):—------==— -------------- ------------------------------------- <br />rLTfSln^h^ p^'^o^e^t^m^sure the hot and coK! ho.d.ng of potential hazardous <br />, am prevZg9 hot holding of ail potentially hazardous foods above <br />135°F: ■ <br /> Camp stove tyStemo & hotel trays <br />| | Double steamer Steam table & lids <br /> Electric stove top O Other (specify) <br />Examples of potentially hazardous food include: <br />vegetables, potato salad, eggs, and dairy products. <br />H'Yes No <br />Phone: (). <br />SANJOAOUIN <br />-------COUNTY <br />Greatness grows <br />TEL. <br />xr: F Vl -1 Name of Event —t—- (J ' <br />Name of organization/business. 7" <br />Address:f <br /> — Alternate. ( ) - <br />Phone: <br />List food to be sold or given to the public: ------------- <br />, am providing food that is NOT prepared at home: <br />All food is prepared on-site or is from approved commercia <br /> <br />Name of facility: - ----------------------------- <br />fam^ov°ding7b^Sh^^^ <br />-SA booth with walls and ceiling constructed of either dSlXr (concrete^ <br />Xd Stable) and constructed to separate food and food prep <br />areas from the public.