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Date(s): April 15, 16 & 17, 20161. <br />2. <br />3. <br />4. <br /> NoH Yes <br />5. <br />6. <br />7. <br />8. <br />9. <br />Page 1.'2 Rev 10 I-* 2015 <br /> Electric stove top <br /> Other (Specify) <br /> Approved bottled water <br />S^Hose-bib on-site at the festival. <br /> <br /> Other (specify):__------------------ <br />Vendors <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 />Name of Event: San Joaquin Asparagus Festival <br />I am protecting my unpackaged food and food-preparation areas from flies, dust and the public by the <br />following methods: <br />WA booth with walls and ceiling constructed of either wood, canvas, plastic, similar material and fine <br />mesh fly screening, completely enclosing open food aieas. <br /> A booth with a smooth and cleanable floor (concrete, asphalt, clean tarps and smooth wood are <br />acceptable). <br />a booth constructed to separate food and food preparation areas from the public. <br /> 1=1 Note: to provide enclosed booths are those which sell bevels from <br />approved dispensers, or prepackaged foods from approved sources. <br />Approved water (or drinking, utensil and hand washing will be provided in my booth by the following methods: <br />The following is information about my organization/business: <br />Name of -SW-. <T A/rW, dp’ <br />Arters- wrzg ^■srcr/vz.-, a— <br />Phone: Alternate:------//fe -------------- <br /> <br />List food to be sold or given to the public: I <br />I am providing foods that are not homemade: E] Yes No <br />All foods are prepared on-site or are from approved commercial facilities. <br />Name of facility: A iVX -S------C L *-•' — ---------------------------- - ------ <br />E.H. Permit #:.____________ _—_-----------—------------------------------- --------- <br />Electricity is provided for my booth’s use: j^Yes No <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 No <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 <br />[SjSterno & hotel trays Steam table & lids <br />Note: Potentially hazardous food examples: meats, tamales, cooked beans, rice, vegetables, potato <br />salad, eggs and dairy products. <br />vendors@SanJoaqiiinAsparagusFestival.net • 916-370-3647 phone • 209-234-1780 fax