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Environmental Health Department <br />I <br />02/02/20231.Date(s): <br />2. <br />Address: <br />3. <br />4. <br />5. <br />6.Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods: <br /> Approved bottled water. <br />9. <br />meats, tamales, cooked beans, rice, <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 /> Stemo & hotel trays <br /> Steam table & lids <br /> Other (specify) <br />7. <br />8. <br /> A 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 />|X| Other (spedfy): 10x10 covered tent be we have pre-packaged foe <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />EHD 16-02 Page 7 of 11 TEMP EVENT APP <br />06/19/19 <br />SAN JOAQUIN <br />------COUNTY------ <br />Greatness grows here. <br />TEMPORARY FOOD VENDOR’S APPLICATION <br />Note: Examples of potentially hazardous food include: <br />vegetables, potato salad, eggs, and dairy products. <br /> On-site hose bib that is connected to a potable water source. <br />K Other (spedfy): n/a <br />Eledridty is provided for my booth’s use: K Yes No <br />I am providing an accurate probe thermometer to measure the hot and cold holding of potentially hazardous <br />foods during all times of booth operation: Yes No <br />I am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br />135°F: <br /> Camp stove <br /> Double steamer <br /> Electric stove top <br />The following is information about my organization/business: <br />Name of organization/business: FreSZS Dried Emporium <br />1761 Franklin Canyon R< Martinez, CA 94553__________ <br />925 381-4567 Alternate* / 1 925-212-807CPhone: (g^ ) 00 1-400/ Alternate^ ) <br />List food to be sold or given to the public: pre-packaged freeze dried candies, fruits, veggies, <br />snacks, and ice creams (all freeze dried) <br />I am providing food that is NOT prepared at home: Yes No <br />All food is prepared on-site or is from approved commercial facilities: KI Yes No <br />Name of facility: Approved & Licensed CFO #7548£ Phone. (925)381-4567 <br />Address of facility: 1761 Franklin Canyon Rd. Martinez, CA 945; <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 />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 />1. Name of Event: StOCktOn Flavor Fest