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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: The Tequila Festival Date(s): 8/17/2019 <br /> . <br /> 2. The following is information about my organization/business: <br /> Name of organizationibusiness: Rincon Taxqueno <br /> Address: 2900 E. Harding Way Stockton, CA <br /> Phone: (209 ) 401-2181 Alternate: ( ) <br /> 3. List food to be sold or given to the public: Tacos, Burritos, Quesadillas, Asada fries <br /> 4. 1 am providing food that is NOT prepared at home:LJ Yes❑No <br /> All food is prepared on-site or Is from approved commercial facllities: �es❑No <br /> Name of facility: La Commercial Co. phone:(209 ) 464-4570 <br /> Address of facility: 2900 E. Harding Way Stockton, CA <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 public) <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 tarps and smooth wood are acceptable) and constructed to separate food and food preparation <br /> areas from the public. <br /> L,Other(specify): Food Trailer <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 /> 6. Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods: <br /> Approved bottled water. <br /> ❑On-site hose bib that Is connected to a potable water source. <br /> ❑ Other(specify): <br /> 7. Electricity is provided for my booth's use: Yes❑No <br /> 8. 1 am providing an accurate probe thermometer to measure the hot and cold holding of potentially hazardous <br /> foods during all times of booth operation:,:, 'Yes❑No <br /> 9. 1 am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br /> 135°F: <br /> ❑ camp stove ❑Sterno&hotel trays <br /> ❑ Double steamer j Steam table&lids <br /> ❑Electric stove top ❑Other(specify) <br /> Note: Examples of potentially hazardous food Include: meats, tamales, cooked beans, rice, <br /> vegetables,potato salad,eggs,and dairy products. <br /> EHD 16-02 Page 7 of 11 TEMP EVENT APP <br /> 08/0111 B <br />