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/do /o I <br />Environmental Health Department <br />Date(s): June 7th & 8th <br />2. <br />Address:.2440 s Airport Way, Stockton 95206 <br />Phone:(209 <br />3. <br />4. <br />5. <br />6. <br />9. <br />meats, tamales, cooked beans, rice, <br />7. <br />8. <br />event. <br />1. Name Of Event: Manteca Watermelon Street Fair <br />The following is information about my organization/business: <br />Name of organization/business: Alexa Plate Taco <br />SANJOAQUIN <br />COUNTY <br />or given to the public: <br />TEMPORARY FOOD VENDOR’S APPLICATION <br />Zired to return a si9ned and completed copy °f this checWist to <br />1. <br />tn <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 /> On-site hose bib that is connected to a potable water source. <br /> Other (specify): <br />Electricity is provided for my booth’s use: E Yes No <br />' ZH?9 ^uaCCUrart! P?6 thermom4ter to measure the hot and cold holding of potentially hazardous <br />foods during all times of booth operation: H Yes No <br />1 Providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br />I *50 i . <br />H Camp stove E Stemo & hotel trays <br />E Double steamer E 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 />EHD ?6^2 Hazelton AvGnue 1 Stockton, California 95205 I T 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />07/01/2024 Pa9e 7 °f 11 TEMP EVENT APP <br />______________ Alternate: ( ) <br />Tacos, Burritos, Quesadillas, Asada Fries, Tortas, Flautas, Came Asada Plate <br />.Chulfita Ahumada Nachos Carnitas Plate. Chile RellAnn Rirria, QiiACAhirri^ <br />. , Meats: Asada, Carnitas, Chicken, Pastor, Chorizo, Buche, Suadero <br />I am providing food that is NOT prepared at home: B Yes No <br />All food is prepared on-site or is from approved commercial facilities: E Yes No <br />Name of facility: Costco <br />y —---------------------------------------------------------------------Phone: (209 ) 825-8200 <br />Address of facility: 2440 Daniels St, Manteca, Ca 95337 <br />1 XP and the puHta? Wfth n9: (t° protect my unpacka9ed f°°d and food-preparation areas from flies, ‘ <br />BeAeniOn°nthrnmnSr i06"'"9 cons‘™cted °f ei,her wood’ “nvas. plastic, similar material and fine mesh fly <br />9i ™p e ly ®nclos,ng °Pen food areas- K will also have a smooth and cleanable floor (concrete* <br />Zs tamTe puMc3 Sm°Oth W0°d are acceptable> and instructed to separate food and food preparation <br /> Other (specify): <br />) 597-4714 <br />List food to be sold