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Date(s): April 15,16 & 17.2Q1£ <br />1. <br />2. <br />3. <br />4. <br /> NoS Yes <br />5. <br />6. <br />8. <br />9. <br />Pagsl/2 Rm 10T14S015 <br /> Electric stove top <br /> Other (Specify)— <br />Q L JB|a|■7 afipd imi-om iJWiFiAn Qi.r>7 <br /> Approved bottled water <br /> Hose-bib on-site at the festival. <br /> Other (specify):_-------------- ------ - ------------------------- ------------------- -- <br />Electricity is provided for my booth’s use; Yes No <br />I an priding an accurate pob. thennomger to measure the hot and cold holding of potentially hazardous <br />foods during all times of booth operation: M Yes U No <br />following hot temperature control for the hot holding of all potentially hazardous foods <br />Name of Organization/Business: <br />Aririrre*:. <br />Phone: ___ <br />Vendors show. <br />Ail 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 />The following is information about my oiganization/business: <br />All -STft-M <br />I am providing the <br />"above 140° F: <br /> Camp stove Double steamer <br /> Sterno & 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 />wmlBrs@Saii4oaquinAsparaiusFestiwal.net • 916-370-3647 plume • 205-234-1780 lax <br />PIPS' — <br /> SiMStiyi ‘hf <br /> Alternate: Tt? T W — <br /> uet food to ho sold or given <= ths public:,. PBUf >Kl..Xg---------- <br />I am providing foods that are not homemade: E Yes <br />All foods are prepared on-site or are from approved commercial facilities. <br />Name of facility.—------------------------------------ - <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 />a 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 />® 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 /> D S: She cooperations not required to proviSTenclosed booths are those which sell bevels 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;