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1. Name of Event: Poorba's Disco Dandiya and Poorba's Durga Puja1.Date(s): 10/4, 10/5. 10/6 <br />2.The following is information about my organization/business: <br />Name of organization/business: S B K Foods Inc. DBA Urban Momo <br />2705 Stoneridge Drive, Suite B, Pleasanton, CA, 94588Address: <br />( 925 >523-2028Phone: <br />3. <br />4. <br />5. <br />0 Other (specify): <br />Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods:6. <br /> Approved bottled water. <br /> On-site hose bib that is connected to a potable water source. <br />9. <br />meats, tamales, cooked beans, rice, <br />7. <br />8. <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 />0 Sterno & hotel trays <br />0 Steam table & lids <br />0 Other (specify) <br />Environmental Health Department <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 />06/29/2023 , <br />Prd d rocd U +- S - | Iq <br />SAN JOAQUIN <br />-----COUNTY----- <br />Greatness grows here <br />TEMPORARY FOOD VENDOR’S APPLICATION <br />0 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, clean 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 />Note: Examples of potentially hazardous food include: <br />vegetables, potato salad, eggs, and dairy products. <br />0 Other (specify): <br />Electricity is provided for my booth’s use: 0 Yes 0 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: 0 Yes 0 No <br />I am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br />135°F: <br />0 Camp stove <br />0 Double steamer <br />0 Electric stove top <br />Alternate: (415 ) 964-8800 <br />List food to be sold or given to the public: Mom0’ Chowmein, Gorkhali Chilli, Manchurian <br />I am providing food that is NOT prepared at home: 0 Yes 0 No <br />All food is prepared on-site or is from approved commercial facilities: 0 Yes 0 No <br />Name of facility: Urban Momo Phone: ( ) <br />Address of facility:2705 Stoneridge Drive, Suite B, Pleasanton, 94588 <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)