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REC-008 <br />SAN JOAQUIN <br /> <br />Environmental Health Department <br />—C•UNTY <br />Greatnes qrc), <br />TEMPORARY FOOD VENDOR'S APPLICATION <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 />Music in the F <br />1.Name of Event: Date(s): 111111=111164 <br />The following is information about my organization/business: <br />Name of organization/business: Los Primos Tex-Mex Food LLC <br />Address: 2471 North Naglee Road Suite 100 #1030 <br /> <br />Phone: 773-708-1214 Alternate: 209-884-0191 <br /> <br />List food to be sold or given to the public: Tacos, Burritos, Fries, Nachos, Quesadillas <br />I am providing food that is NOT prepared at home:[}esjJo <br />All food is prepared on-site or is from approved commercial facilities: <br />Name of facility: Commissary Modesto <br />Address of facility:1211 S 7th Street <br />Phone: 209-362-9123 <br /> <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 />booth with walls and ceiling constructed of either wood, canvas, plastic, similar material and fine mesh fly <br />sc eening, 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 />1-1)ther (specify): Food Truck <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 />TlApproved bottled water. <br />1-1)n-site hose bib that is connected to a potable water source. <br />ther (specify): Food Truck Water system <br />No <br />asure the hot and cold holding of potentially hazardous <br />No <br />"TTF"x• the hot holding of all potentially hazardous foods above <br />R5°F: <br />amp stove <br />ouble steamer <br />lectric stove top <br /> <br />Sterno & hotel trays <br />Steam table & lids <br />Other (specify) <br /> <br />Note: Examples of potentially hazardous food include: meats, tamales, cooked beans, rice, <br />vegetables, potato salad, eggs, and dairy products. <br />1868 E. HazeIton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sigov.orglehd <br />END 16-62 Paige 7 of 11 TEMP EVENT APP <br />06/19119 <br />Ri <br />E1tricity is provided for my booth's use 1 Ye <br />I am providing an accurate probe therm r <br />foods during all times of booth operation 1 Yes <br />I am providing the following hot 1emperatu7Tontro