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a 001/002 <br /> <br />□ate(a): April 1$, 16 & 17, 2016Name of Event: San Joaouln AeparaguB Festival1, <br />2. <br />3. <br />List food to be sold or given to the public:. 4. <br /> No <br />5. <br />6. <br /> No'as7. <br />3. <br />F’^jo \fi Rov l0/MZ201fl <br />03/21/2016 16:18 FAX <br />* <br />_j No <br />lommercial facilities: Yea <br />(AJ(Mi// <br />, Alternate:^ <br />Vendors n<^?n compliancf^canbe aS2Pt<ydose?heirH^oth'afid flrf^t the show. <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 />I am providing foods that are not homemade: <br /> All foods are prepared c>n-slte or are frgm apprtfve&~co( <br />Name of facility: W. / / " /v' <' ^-£2----- <br />E.H. Permit #:------------------------------------------------------ <br />I am protecting my unpackaged food and food-preparation areas from files, duet and the public by the <br />following mefbods; <br />/0A booth with walls and celling constructed of either wood, canvas, plastic, similar material and fine <br />■ mesjifirScreenlng, completely enclosing open food areas. <br />ra^booth with a smooth and cleanable floor (concrete, asphalt, clean tarps and smooth wood are <br />acceptable). <br />booth constructed to separate food and food preparation areas from the public. <br /> Other (speolfy):__.................______-------------.——------------------ <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; <br /> Approved bottled water <br />Sl^ose-bib on-site at the festival. <br /> Other (specify): <br />The following is information about my organlzatlon/business: <br />Name of Organlzation/Buslneaa: t I /"T'S <br />Addresa:l\i <br />Phone: <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 ell times of booth operation^05fes 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 Electric stove top <br /> Stemo & hotel trays Q Steam table & lids Other (Specify)--------------------- ------------- <br />Note: Potentially hazardous food examples: meats, tamofes, cooked beans, rice, vegetables, potato <br />salad, eggs and dairy products. <br />vendors@SanJoaquinAsparagusFestivfll.net • 916-370-3647 phone • 209-234-1780 fax