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Environmental Health Department <br />i.Date(s): October 4, 2025 <br />2. <br />Phone: <br />3. <br />4. <br />5. <br />those which sell beverages from <br />6. <br />9. <br />meats, tamales, cooked beans, rice, <br />7. <br />8. <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 />KI Approved bottled water. <br />The following is information about my organization/business: <br />Name of organization/business: Row’s Roll <br />Address: 16201 S Harlan Rd Lathrop CA 95330 <br />( 408) 807-2326 Alternate: ( ) <br />List food to be sold or given to the public: LumPia. panat, Ube horctiata. Ube iced coffee, calamamsi juice. Ube lemonade <br />,° a si9ned and comi>iete<) <br />1. Name of Event: Pride Fest 2025 <br />™ 02 HaZeltOn Avenue 1 Stockton-California 95205 | TJ09 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />07/01/2024 PsgGZofll TEMP E'.'ENT APR <br />I am providing food that is NOT prepared at home: K Yes No <br />All food is prepared on-site or is from approved commercial facilities: K Yes No <br />Name of facility: Row’s Roll ________Phone: (408 )807-2326 <br />Address of facility: 16201 S Harlan Rd Lathrop CA 95330 <br />I am providing a booth with ths following.- (to protect my unpackaged food and food-preparation areas from flics <br />dust and the public) <br />KI A booth with walls and ceiling constrocted of either wood, canvas, plastic, similar material and fine mesh flv <br />screening completely enclosing open food areas. It will also have a smooth and cleanable floor (concrete <br />areas fromethetpubBcand Sm00th WOOd are accePtabte) and constructed to separate food and food preparation <br /> Other (specify): <br />rm in a num <br />dAIN JUAUUIIN <br />COUNT Y------- <br />Greatness grows here. <br />TEMPORARY FOOD VENDOR’S APPLICATION <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: KI Yes D No ' -- ----------------- <br />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: KI Yes No <br />1 a™ P|?vidin9the following hot temperature control for the hot holding of all potentially hazardous foods above <br />135 F: <br /> Camp stove [2] Stemo & hotel trays <br /> Double steamer steam table & lids <br /> Electric stove top KI Other (specify) Hot <br />Note: Examples of potentially hazardous food include: <br />vegetables, potato salad, eggs, and dairy products. <br />r