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Environmental Health Department <br />6/3/231.I.Nameof Event: Date(s): <br />2. <br />Address: <br />708-1214 <br />Phone: <br />List food to be sold or given to the public:3. <br />4. <br />338-3663 <br />5. <br />Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods:6. <br />0 Approved bottled water. <br />9. <br />meats, tamales, cooked beans, rice, <br />The following is information about my organization/business: <br />Los Primos Tex-Mex Food <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 /> Sterno & hotel trays <br /> Steam table & lids <br /> Other (specify) <br />7. <br />8. <br />Name of organization/business: <br />2365 East St Tracy CA 95376 <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 />06/19/19 <br />SAN JOAQUIN <br />------COUNTY------ <br />Greatness grows here. <br />TEMPORARY FOOD VENDOR’S APPLICATION <br />209 <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 />Kite Festival <br />Note: Examples of potentially hazardous food include: <br />vegetables, potato salad, eggs, and dairy products. <br />773 <br /> Alternate: ( ) <br />Mexican Food, Tacos, burritos, quesadillas, tostadas, fries. <br /> On-site hose bib that is connected to a potable water source. <br />Food Truck water <br />0 Other (specify): <br />Electricity is provided for my booth’s use: 0 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: 0 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 />0 Double steamer <br /> Electric stove top <br />P uiks ' <br />I am providing food that is NOT prepared at home: 0 Yes No <br />All food is prepared on-site or is from approved commercial facilities: 0 Yes No <br />Nameol facility: La M°dest°Phone: f 209 1 <br />Address ol facililv: 1711S. 7th Street <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 />884-0191 <br /> 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 taras-dncT’smSoth wood are acceptable) and constructed to separate food and food preparation <br />areas from the pdblic. <br />\ Food truck J <br />0 Other (specify^:-Z_________________________________________________________