Laserfiche WebLink
Environmental Health Department <br />5/14/26 - 8/27/26Date(s):1. <br />2, <br />3. <br />4. <br />5. <br />6. <br />9. <br />Not Applicable <br />meats, tamales, cooked beans, rice, <br />vegetables, potato salad, eggs, and dairy products. <br />SANJOAQUIN <br />------COUNTY------- <br />GrccHneii yroivs lune. <br />TEMPORARY FOOD VENDOR’S APPLICATION <br />7. <br />0. <br />Electricity is provided for my booth's use: Yes (kJ No <br />foods during all times of booth operation: [3 Yes O No <br />lamr <br />135°F: <br /> Camp stove <br /> Double steamer <br /> Electric stove top <br />Note: Examples of potentially hazardous food include: <br /> Approved bottled water. <br /> On-site hose bib that Is connected to a potable water source. <br />E Other (specify): 5 9allon Insulated container warm waler dispener wilh liquid soap, paper towels, end waste water bucket <br />Electricity is provided for my booth's use: Yes 0 No <br />I am providing an accurate probe thermometer to measure lhe hot and cold holding of potentially hazardous <br />M holding of ell pelonUrty hnznrdou, foods shove <br /> Sterno & hotel trays <br /> Steam table & lids <br /> Other (specify) <br />The following Is information about my organization/business: <br />, . . , Saint Pete's Bakery Name of organization/business:__________________i <br />1849 Orvis Drive, Stockton, CA 95209 <br />I860 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjcehd com <br />EH016 02 Page 7 0(11 7EMP EVENT APR <br />07/3/17 <br />.....-'b <br />All food vendors (both for profit and non-profit) are required to return a signed and completed copy of this checklist to <br />lhe festival coordinator three (3) weeks prior to this event. <br />1 Name of Event: Lodi Certified Farmers Market <br />Address: <br />Phone: (209 ) 639-5913 Alternate: ( ) <br />List food (O be sold or given to the Dubiic:Sourdough Baked Goods (Bagels Cookies, Scones, Muffins, <br />Pancake Mix), Cream Cheese, Cold Brew Coffee & Tea <br />I am providing food that Is NOT prepared at home: E Yes No (Cream Cheese, Cold Brew Coffee & Tea) <br />All food Is prepared on-site or Is from approved commercial facilities: E Yes No <br />Name of facility: Stockton Community Kitchen Phone: ( 209) 949-2104 <br />Address of facility: 110 N, El Dorado, Stockton. CA 95202 <br />I am providing a booth with the following: (to protect my unpackaged food and food-preparation areas from flies, <br />dust and the public) <br /> A booth with walls and celling constructed of either wood, canvas, plastic, similar material and fine mesh fly <br />screening, completely enclosing open food areas. It will also have a smooth and cleanable floor (concrete, <br />asphalt, clean tarps and smooth wood are acceptable) and constructed to separate food and food preparation <br />areas from the public. <br />[X-] 0(her (specify):AI1 prepackaged. Nitro Coffee & Tea will be dispensed from kegs Into disposable cups. <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: