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7 <br />Environmental Health Department <br />2. <br />3. <br />4. <br />5. <br />6. <br />9. <br />meats, tamales, cooked beans, rice, <br />7. <br />8 <br />SAN JOAQUIN <br />COUNTY <br /><o- <br />Haze.,an Avenue I Stockton, California 95205^^209 468-34201 F 209 464-0138 | www Wvorg/ebd^ <br /> <br />Note: The only operations not required to provide enclosed booths are those which sell beveraoes from <br />approved dispensers, or prepackaged foods from approved sources. Beverages from <br />Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods: <br /> Approved bottled water. <br /> On-site hose bib that is connected to a potable water source. <br />Efother (specify). 4 6^1^ <br />Electricity is provided for my booth’s use: H'Ves No ------------------------- <br />1 □ Nr'’o, “'d ho,din9 o' pote""ai1’ toa'dous <br />I am^providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br />[—1 ^amP stove Q Stemo & hotel trays <br /> Double steamer Q cteam ^^6 & |jds <br /> Electric stove top S'Other (specify) MOW <br />O^Note: Examples of potentially hazardous food include: <br />I vegetables, potato salad, eggs, and dairy products. <br />TEMPORARY FOOD VENDOR’S APPLICATION <br />"isrss, 10a si!,nM a,,d comp"5',!<, e°w °"his ch“ki»' <br />1. 1. Name of Event. 6TZV-W ______OaMS,^W H <br />The following is information about my organization/business: <br />Name of organization/business: Uw <br />Address: ■ ^9^)^ <br />Phone: Alternate: ( ) <br />List food to be sold or given to the public: <br />I am providing food that is NOT prepared at home: Q^Yes Q No / <br />All food is prepared on-site or is from approved commercial facilities: Qves No <br />Name of facility:------------------------------------------------------------------phone: ( ) <br />Address of facility: <br />ancl .ce'.lin9 coveted of either wood, canvas, plastic, similar material and fine mesh fly <br />9; cor?pletely enclosing open food areas. It will also have a smooth and cleanable floor (concrete <br />areas JomTepuMc3 aCCeptable) and “n^cted to separate food and food preparation <br />0 Other (specify):