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image 1.jpeg• 10/3/25,1:28 PM <br />Environmental Health Department <br />TEMPORARY FOOD VENDOR’S APPLICATION <br />Date(s): 10/18/2025MOUNTAIN HOUSE DIWALl MELA I.Name of Event:1. <br />The following is information about my organization/business:2. <br />Name of organization/business: DHABA INDIAN CUISINE <br />2242 W. GRANTLINE RD TRACY CA 95377 Address: <br />) Alternate: (Phone: <br />3. <br />4. <br />5. <br /> Other (specify): <br />Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods:6. <br />03 Approved bottled water. <br /> On-site hose bib that is connected to a potable water source. <br />9. <br />i/ihttps://mail.google.com/mail/u/3/#inbox?projector=1 <br />13 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 />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 />(3 Stemo & hotel trays <br /> Steam table & lids <br /> Other (specify) <br />7. <br />8. <br />(209 ) 835-9090 <br />List food to be sold or given to the public: CHOLLEY BHATURE, SAMOSA, CHAAT & SNACKS <br />SAN JOAQUIN <br />------COUNTY------ <br />I am providing food that is NOT prepared at home: S Yes No <br />All food is prepared on-site or is from approved commercial facilities: (3 Yes No <br />Name of facility: DHABA INDIAN CUISINE Phone: (209 ) 835-9090 <br />Address of facility: 2242 W. GRANTLINE RD TRACY CA 95377 <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 />Note: Examples of potentially hazardous food include: <br />vegetables, potato salad, eggs, and dairy products. <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 />meats, tamales, cooked beans, rice. <br /> Other (specify): - _________________________________ <br />Electricity is provided for my booth’s use: S 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: [X] 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