Laserfiche WebLink
< <br />Environmental Health Department <br />Date(s): 1. <br />2. <br />Address: <br />Phone: <br />3. <br />4. <br />K: <br />5. <br />the hot and cold holding of potentially hazardous <br />meats, tamales, cooked beans, rice, <br />- 1 <br /> Other (specify):_ __________________ <br />Note: The only operations not required to provide enclosed booths <br />—COUNTY----- <br />Greatness grows here. <br />TEMPORARY FOOD VENDOR’S APPLICATION <br />I <br />K, <br />If <br />I <br />I <br />SANJOAQUIN <br />209 464-0138 | “sj90*p0Er9'^PP <br />■ <br />BP stove <br />&e steamer <br />||c stove top <br />E <br />vegetables, potato salad, eggs, and dairy products. <br />ffion Avenue | Stockton, California 95205 | T 209 468-3420 | F <br />Page 7 of 11 <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 />fev' <br />©Approved bottled water. <br />®On-site hose bib that is connected to a potable water source. <br />3® <br />fX Yes n No <br />Phone: (1 <br />The following is information about my organization/business: <br />Name of organization/business: <br />UlSH Aurora <br />~~ U1 Alternate: ( )--------------------------------------- <br />List food to be sold or given to the public: pQi <br />I am providing food that is NOT prepared at home: [XYes □ No <br />All food is prepared on-site or is from approved commercial facilities: <br />Name of facility:_ _________ <br />Address of facility:________________ <br />I am providing a booth with the following: (to protect my unpackaged food and food-preparation areas from flies, <br />dust and the public) <br />0A booth with walls and ceiling constructed of either wood, canvas, plastic, similar material and fine mesh fly <br />^screening, completely enclosing open food areas, it will also have a smooth and cleanable floor (concrete, <br />asphalt, dean tarps and smooth wood are acceptable) and constructed to separate food and food preparation <br />areas from the public. <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 coordinator three (3) weeks prior to this event. <br />I.Name of Event: <br />pies of potentially hazardous food include: <br />bther (specify): -------------------------- —=4--------- <br />Sricity is provided for my booth's use: Yes No <br />Eproviding an accurate probe thermometer to measure <br />jfcSg the fo^nXuXeraturS?ol foMhe hot holding of all potentially hazardous foods above <br /> Sterno & hotel trays <br /> Steam table & lids <br /> Other (specify)