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Environmental Health Department <br />WatermelonsUeetfaif1.1-Name of Event:Date{s): <br />2. <br />Address: <br />Phone:() Alternate: () <br />List food to be sold or given to the public: 3. <br />4. <br />5. <br />Self contained Food trailerOther (specify): <br />Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods:6. <br /> Approved bottled waler. <br />9 <br />meats, tamales, cooked beans, rice, <br />7. <br />8. <br /> Sterno & hotel trays <br />Fl Steam table & lids <br /> Other (specify) <br />1868 E Hazelton Avenue | Stockton. California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />EH0 T6-02 Pi»g« 7 ol 11 TEMP EVENT APP <br />06/29/2023 <br />June 6-7, <br />2026The following is information about my organization/business: <br />Name of organization/business: CrepeTea___________ <br />P.O. Box 692012 stockton ca 95269 <br /> On-site hose bib that is connected to a potable water source. <br />_____Self contained Food trailer __ <br />*Yes O No <br />ieler to measure the hot and cold holding of potentially hazardous <br />V'Yes No <br />SAN JOAQUIN <br />-----COUNTY------- <br />G ca’ness grows nere. <br />TEMPORARY FOOD VENDOR’S APPLICATION <br />All food vendors (both for profit and non-profit) 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 />qQI Other (specify):_________________X <br />Electricity is provided for my booth’s usp*fi <br />I am providing an accurate probe thermo? <br />foods during all times of booth operation: <br />I am providing the following ho! temperature c’bntrol for the hot holding of all potentially hazardous foods above <br />135 F: <br />0 Camp stove <br />Pl Double steamer <br />O Electric stove lop <br />Noto: Examples of potentially hazardous food Include: <br />vegetables, potato salad, eggs, and dairy products. <br /> A booth with walls and ceiling constructed of either wood, canvas, plastic, similar material and fine mesh fly <br />screening, completely enclosing open food areas. Il will also have a smooth and cleanable floor (concrete, <br />asphalt, dean tarps and smooth wood are acceptable) and constructed to separate food and food preparation <br />areas from the public. <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 />I am providing food that is NOT prepared at home: D Ye^^No'X^ <br />All food is prepared on-site or is from approved commercial facilitiesyC Yes O No <br />Name of facility: California food truck wasn. Xone(209)) 464-9707 <br />Address of facility:----- -—730 California st. Stockton ca-95206------------— <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)