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Environmental Health Department <br />TEMPORARY FOOD VENDOR’S APPLICATION <br />required to return a signed and completed copy of this checklist to <br />1.Date(s): December 7, 2024 <br />2. <br />Address: <br />Phone: <br />3.List food to be sold or given to the public: 3. <br />4. <br />5. <br />6. <br />9. <br />NA <br />meats, tamales, cooked beans, rice, <br />7. <br />8. <br />SAN JOAQUIN <br />C. OU NT V <br />The following is information about my organization/business: <br />Name of organization/business: YaYa'« Investments LLC, dba Cruising Cones 6 <br />11222 Loduca Dr, Manteca, CA 95336 <br />Hazelton Avenue | Stockton, California 95205 I T 209 468-3420 | F 209464-0138 | www.sjgov org/ehd <br />06/29/2023 age 7 of 11 TEMP EVENT APP <br />( 209 ) 993-2461 cell <br />Note: 2perations not recluired to provide enclosed booths are those which sell beveraqes from <br />pp oved 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 /> On-site hose bib that is connected to a potable water source. <br />S Other (specify): municipal water in holding tank <br />Electricity is provided for my booth’s use: Yes H No <br />I am providing an accurate probe thermometer to moasi <br />foods during all times of booth operation: S Yes No <br />All food vendors (both for profit and non-profit) are i <br />the festival coordinator three (3) weeks prior to this event. <br />1. Name of Event: Christmas in the Park 2024 <br />- bottled water for drinking ______________ <br />using Generators <br />measure the hot and cold holding of potentially hazardous <br />' a™5P™iding the followi"9 hot temperature^lon^oUe/the hot holding of all potentially hazardous foods above <br /> Camp stove Sterno & hotel trays <br /> Double steamer Q steam table & lids <br />O Electric stove top Q Other (specify) <br />Note: Examples of potentially hazardous food include: <br />vegetables, potato salad, eggs, and dairy products. <br /> Alternate: (209 ) 800-8079 business line <br />I am providing food that is NOT prepared at home: S Yes No <br />All food is prepared on-site or is from approved commercial facilities: S Yes No <br />Name of facility: prepared on site __________________Phone- <br />Address of facility:______ <br />' ^s^andthe pu^M f0"0Win9: (t° Pr°teCt my unpacka9ed food and food-preparation areas from flies, <br />aX ZTepSc S",00tl’ W00d are accep,able> and constructed to separate food and food preparation <br />S Other (specify): Enclosed Trailer