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Environmental Health Department 1. 2. Address: Phone: 3. 4. s 5. Other (specify): Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods:6. Approved bottled water. On-site hose bib that is connected to a potable water source. 9. Note: The only operations not required to provide enclosed booths are those which sell beverages from approved dispensers, or prepackaged foods from approved sources. 1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd EHD 16-02 Page 7 of 11 TEMP EVENT APR 06/29/2023 7. 8. 135°F: Camp stove Double steamer Electric stove top esbE Yes No _____ ________Phone: Zpl 57m I) A SAN JOAQUIN ------COUNTY------- Greatness grows here. TEMPORARY FOOD VENDOR’S APPLICATION All food vendors (both for profit and non-profit) are required to return a signed and completed copy of this checklist to the festival coordinator three (3) weeks prior to this event. 1. Name of Event: Name of organization/business: < 600; El. t\)Ar4-h Alternate: List food to be sold or given to the public:. I am providing food that is NOT prepared at horrie'Q Yes No . All food is prepared on-site or is from approved cpimmercial facilities:' Name of facility: 5t. Address of facility:. I am providing a booth with the following: (to protect my unpackaged food and food-preparation areas from flies, dust and the public) "S A booth with walls and ceiling constructed of either wood, canvas, plastic, similar material and fine mesh fly screening, completely enclosing open food areas. It will also have a smooth and cleanable floor (concrete, asphalt, clean tarps and smooth wood are acceptable) and constructed to separate food and food preparation areas from the public. Date(s))&b~) The following is information about my organization/business: Name of organization/business: 6b ArAhmib CaWdUC Church 9^) Other (specify):K ______________________________________________________ Electricity is provided for my booth’s use: N Yes No I am providing an accurate probe thermometer to measure the hot and cold holding of potentially hazardous foods during all times of booth operation?^] Yes No I am providing the following hot temperature control for the hot holding of all potentially hazardous foods above "''S0 Sterno & hotel trays Steam table & lids Other (specify) | e^CtVlC Note: Examples of potentially hazardous food include: meats, tamales, cooked beans, rice, vegetables, potato salad, eggs, and dairy products.