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Environmental Health Department <br />1. Name of Event: Mountain House Diwali Mela1.Date(s): 10/18/2025 <br />The following is information about my organization/business:2. <br />Name of organization/business: Tandoori Pizza <br />1140 Tradition St, Mountain House, CA 95391Address: <br />(209 ) 784-8100Phone:Alternate: () <br />List food to be sold or given to the public: Pizza & Soft Drinks3. <br />4. <br />5. <br /> Other (specify): <br />6. <br />9. <br />meats, tamales, cooked beans, rice, <br />Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods: <br />0 Approved bottled water. <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 />7. <br />8. <br />[x] 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 />[x] Stemo & hotel trays <br />I I Steam table & lids <br /> Other (specify) <br />[xj On-site hose bib that is connected to a potable water source. <br />D Othar (Rparify): _____ _ <br />Electricity is provided for my booth’s use: H Yes No <br />I am providing an accurate probe thermometer to measure the hot and cold holding of potentially hazardous <br />SAN JOAQUIN <br />------COUNTY------- <br />brcniness gror.-5 hsre. <br />TEMPORARY FOOD VENDOR’S APPLICATION <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 />07/01/2024 <br /> <br /> <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 />foods during all times of booth operation: S Yes No <br />I am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br />135T: <br /> Camp stove <br /> Double steamer <br />S Electric stove top <br />Note: Examples of potentially hazardous food include: <br />vegetables, potato salad, eggs, and dairy products. <br />I am providing food that is NOT prepared at home: H Yes No <br />All food is prepared on-site or is from approved commercial facilities: S Yes No <br />Name of facility: Tandoori Pizza Phone: ( 209 ) 784-8100 <br />Address of facility: 1140 Tradition St. Mountain House. CA 95391 <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)