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SAN JOAQUIN Environmental Health Department <br /> TEMPORARY FOOD VENDOR'S APPLICATION <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 /> 1 1 Name of Event: Red White Brew wine and b rl st Date(s)Nov 28th 2024 <br /> 7 The following is information about my organizationlbusiness <br /> Name of organ izationlbusiness. Hog House BBQ <br /> Address 133 N GRANT AVENUE MANTECA <br /> Phone (209) - 1 l Alternate: ( ) <br /> 3 List food to be sold or given to the public: Ribse brisket pulled pork, sausage, mac beans cornbread <br /> a 1 am providing food that is NET,prepared at home [g Yes ❑ No <br /> All food is prepared on-site or is from approved commercial facilities: X Yes ❑ No <br /> Name of facility' - <br /> Address of facility: _ <br /> 5. 1 am providing a booth with the following. (to protect my unpackaged food and food-preparation areas from flies, <br /> dust and the publir.) <br /> A tsnoth rvdh YAWS stela ,Xllinq coostructnrt a(Rdhr)r rw(so(.l. ::.irvats, viastic, siwilai iviatorkil and fine mash `1y <br /> %reeninq, completely onclosincf v!)en fond areas #t rnlf also t3avr) ,..I smooth and claanabiu Roar (concrt:te, <br /> asprtaii. (:loan tarps ansi smooth wood are ;tccx)ptabla) -Ind construct0d to s+:s:ztrnte food �ru:l food pm%paralion <br /> arras from the public:. <br /> ❑Other(specify): <br /> Note: The only operations not required to provide enclosed booths are those which sell beverages from <br /> approved dispensers, or orepackaged foods from appmved sources. <br /> 6 Approved water for drinking. utensil and hand washing will be provided in my booth by the following methods. <br /> Approved boltled water. <br /> ❑ On-site hose bits that is connected to a potable water source. <br /> [—J Other{specify) - — — <br /> 7 Eiectncity Is provided for my booth's use-IJ Yes) No <br /> a I am providing an accurate probe thermometer to measure the hot and cold 'holding of potentially hazardous <br /> foods dunng all times of booth operation ❑Yes ❑No <br /> 9 1 am providing the following hot to control for the hot holding of all polentiaily hazardous foods above <br /> 135"p: <br /> ❑ Camp stove ❑Sterno& hotei trays <br /> ❑ Douote steamer ❑Stearn table& lids <br /> ❑ Electric stove tap X Other(specify) Electric food wormer <br /> Note: Examples of potentially hazardous food Include: meats, tamales, cooked beans, rice, <br /> vegetables, potato salad, eggs, and dairy products. <br /> i <br /> 'F;MF' •lQKT"P <br />