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Date(s): April 15.16 & 17, 20161. <br />2. <br />3. <br />4. <br />5. <br />6. <br />8. <br />9. <br />• 916-370-3647 phone • 209-234-1780 fan <br />Page 1/2 Rev 10/14Z2015 <br />All food vendors (both for profit and non-profit) are <br />Vendors n^tn co^iancFran^ aSedV^oseVheir^ootiyand°rt“ the show. <br />required to return a signed and completed copy of this checklist to <br />the festival organizer two (2) months prior to this event. <br />Name of Event: San Joaquin Asparagus Festival <br /> A booth with walls and ceiling constructed of either wood, canvas, plastic, similar material and fine <br />mesh fly screening, completely enclosing open food areas. <br />tjj&A booth with a smooth and cieanable floor (concrete, asphalt, clean tarps and smooth wood are <br />acceptable). <br /> A booth constructed to sepa^jte food and food preparatbn areas from the public. <br />^Note: the onty^operations not required ^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: <br />6 1 <br />.... : ^Yes EJNO <br /> Yes h(No <br />Tne following is information about my organization/business. <br />Name of Organizatlon/Buslness:------- ------7-------------o o / <br />K.,6-1 <br />Phone ?..>q - 4 ys _-------__ Alternate: S^7 S <br />Liat food to be so!d or given to the publlo: W/ Y <br />I am providing foods that are not homemade: 0 Yes No <br />All foods are prepared on-site or are from approved commercial facilities: <br />Name of facility: kJ d-o.—LlA'Sc/—— <br />E.H. Permit #:_________ _—-----------—---------------------—-----—------------- <br />I am protecting my unpackaged food and food-preparation areas from flies, dust and the public by the <br />following methods: <br /> Approved bottled water <br /> Hose-bib on-site at the festival. <br />piOther (specify): — <br />Electricity is provided for my booth’s use: <br />I am providing an accurate probe thermometer to measure the hot and cold holding of potentially hazardous <br />foods during all times of booth operation: Yes 0J4o <br />I am providing the following hot temperature control for the hot holding of all potentially hazardous foods <br />’above 140° F: <br /> Camp stove Double steamer □Electric stove top / <br />□ Sterno & hotel trays □ Steam table & lids father (Specify)-------H1A------------------ <br />Note: Potentially hazardous food examples: meats, tamales, cooked beans, rice, Vegetables, potato <br />salad, eggs and dairy products. <br />vendors® San Joaquin AsparagusFestivai.ne