Laserfiche WebLink
Environmental Health Department <br />2 <br />3 <br />5 <br />6 <br />9 <br />meats, tamales, cooked beans, rice, <br />| www sigov org/ehd <br />TEMP EVENT APP <br />7. <br />8 <br />SANJOAOUIN <br />-----COUNTY------ <br />Greofnen ijrowA here <br />TEMPORARY FOOD VENDOR’S APPLICATION <br />the festival coordinator three (3) weeks prior to this event. <br />1 <br />Approved water for drinking, utensil and hand washing will be provided m my booth by the following methods <br />[^Approved bottled waler <br /> On-site hose bib that is connected to a potable water source <br /> Other (specify): ._______________________ <br />Electricity is provided for my booth’s use: O Yes 3^0 ~~~~~ <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 />* ai35TVidin9 foll0W,n9 hOt ,ernPera,ure con,ro) for ,he ho’ folding of all potentially hazardous foods above <br /> Camp stove Stemo & hotel trays <br /> Double steamer steam table & lids <br /> Electric stove top Other (specify) <br />Note: Examples of potentially hazardous food Include: <br />vegetables, potato salad, eggs, and dairy products. <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 />1868 E Hazelton Avenue | Stockton, California 95205 | T 209 468 3420 1 F 209 464-0138 <br />EHD 18 0? P*gc7oM1 <br />0&iat9 <br />^>0^. w^orSj(both for profit and non-profit) are required to return a signed and completed copy of this checklist to <br />l .Name of Event:Dale(s) *5111T-Z- <br />The following is information about my organization/busmess <br />Name of organizabon/business <br />Address: <br />w‘t>AflflVVbTM A,t«nate ns^ ) ^09-goN <br />List food to be sold or given to the public. •VwWitX- <br />I am providing foodtna Is Hal prepared al home Q^esQ No , <br />All food Is prepared on-site or»ls from approved commercial facilities 21Yes No <br />Name of facility: A/llfr Phone { > <br />Address of facility: <br />I am a with the following: (to protect my unpackaged food and food-preparation areas from flies. <br />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 />O Other (specify):