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Environmental Health Department <br />2. <br />Address: <br />3. <br />4. <br />993-8391 <br />5. <br />those which sell beverages from <br />6. <br />9. <br />We don't serve hot food <br />meats, tamales, cooked beane, rice, <br />Page 7 of 11 <br />7. <br />8. <br />SAN JOAQUIN <br />-COUNTY------ <br />es No <br />>r to measure the hot and cold holding of potentially hazardous <br />Yes No <br />jntrol for the hot holding of all potentially hazardous foods above <br /> Sterno & hotel trays <br /> Steam table & lids <br />^^ther (specify) <br />Note: Examples of potentially hazardous food include: <br />vegetables, potato salad, eggs, and dairy products. <br />The following is information about my organ ization/business: <br />Name of organlzation/business: pineappleWHIPS, LLC <br />5855 MacArthur Blvd, Oakland, CA 94605 <br />Phone: (510) 993-8391 Alternate: (510 ) 640-2617 <br />List food to be sold or given to the public: PineaPPle WhiP CuPs & Floats with or without fruit t0PPln9s <br /> Date(s): 10/4/25 ~ 10/5/25 <br />I am providing food that is NOT prepared at home: Yes^O No <br />All food is prepared on-site or is from approved commercial facilitieyl^Yes No <br />Name of facility: Pineapple Whips Phone- (510) <br />Address of facility: 5855 MacArthur Blvd, Oakland, CA 94605 <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 />Screening, completely enclosing open food areas. It will also have a smooth and cleanable floor (concrete, <br />area 3f Cl6^in tar^ an^ smoot’1 wo°d are acceptable) and constructed to separate food and food preparation <br /> Other (specify): <br />TEMPORARY FOOD VENDOR’S APPLICATION <br />«t0 re‘Um 3 and C°mple,ed C°W °f this checklist to <br />1. 1. Name of Event: Manteca Pumpkin Fair <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />0^ J Pa0e 7 of11 TEMP EVENT APP <br />Note: The only operations not required to provide enclosed booths are <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 />Approved bottled water. <br />O On-site hose bib that is connected to a potable water source. <br /> Other (specify): <br />Electricity is provided for my booth’s use: NXe <br />I am providing an accurate probe thermqmaei <br />foods during all times of booth operatiorrjQv <br />I am providing the following hot temperatdrecbi <br />135°F: <br /> Camp stove <br /> Double steamer <br /> Electric stove top