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Date(s): April 15,16&17, 2016Name of Event: San Joaquin Asparagus Festival1. <br />2. <br />3. <br />4. <br /> No <br />5. <br />Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods:6. <br />Electricity is provided for my booth’s use: [X| Yes No7. <br />8. <br />9. <br />Page 1/2 Rev 10/14/2015 <br />I am protecting my unpackaged food and food-preparation areas from flies, dust and the public by the <br />following methods: <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: G3 Yes No <br />0 Approved bottled water <br /> Hose-bib on-site at the festival. <br /> Other (specify): <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 />0 A booth with a smooth and cleanable floor (concrete, asphalt, clean tarps and smooth wood are <br />acceptable). <br />0 A booth constructed to separate food and food preparation areas from the public. <br /> Other (specify): <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 />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 organizer two (2) months prior to this event. <br />San Joaquin County FOOD VENDOR HEALTH FORM <br />Vendors not in compliance can be asked to close their booth and forfeit the show. <br /> Electric stove top <br />mt-, , Smoker, Warm Cabinet)□ Other (Specify)____________________ <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 Q Double steamer <br /> Sterno & hotel trays 0 Steam table & lids <br />Note: Potentially hazardous food examples: meats, tamales, cooked beans, rice, vegetables, potato <br />salad, eggs and dairy products. <br />vendors@SanJoaquinAsparagusFestival.net • 916-370-3647 phone • 209-234-1780 fax <br />The following is information about my organization/business: <br />RC HOT DOGS <br />Name of Organization/Business:__________ <br />Address:_ 1112 sutler st Manteca Ca 95336 <br />Phone:209-597-4983 209823-3816 Alternate: 209-740-8093 <br />Bacon wrapped asparagus , smoked chicken wings <br />List food to be sold or given to the public: frozen bananas, ice cream bars , cheese cake , coffee , cocoa <br />I am providing foods that are not homemade: LX Yes No <br />All foods are prepared on-site or are from approved commercial facilities: 0 Yes <br />Name of facility: Union Catering Truck Center _____ <br />E.H. Permit #: 4KE9247