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Dec. 2-3/20161 Name of Event: Manteca Christmas in the park Date(s):1. 2. Name of organization/business: 2900 E. Harding Way Stockton CA. 95205Address: (209 ) 817-4492 Alternate: () Phone: Falafel - Gyros - Chicken - Fries - Salads - Sodas and WaterList food to be sold or given to the public:3. 4. 5. Other (specify): 6.Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods: Approved bottled water. On-site hose bib that is connected to a potable water source. Other (specify): Electricity is provided for my booth’s use: H Yes No7. 8. 9. meats, tamales, cooked beans, rice, Page 7 of 11 TEMP EVENT APPEHD 16-02 7/28/10 Camp stove Double steamer Electric stove top A booth with walls and ceiling constructed of either wood, canvas, plastic, similar material and fine mesh fly screening, completely enclosing open food areas. It will also have a smooth and cleanable floor (concrete, asphalt, clean tarps and smooth wood are acceptable) and constructed to separate food and food preparation areas from the public. Note: The only operations not required to provide enclosed booths are those which sell beverages from approved dispensers, or prepackaged foods from approved sources. I am providing a booth with the following: (to protect my unpackaged food and food-preparation areas from flies, dust and the public) Stemo & hotel trays Steam table & lids Other (specify) The following is information about my organization/business: Go Falafel Greek Food Truck All food vendors (both for profit and non-profit) are required to return a signed and completed copy of this checklist to the festival coordinator three (3) weeks prior to this event. Note: Examples of potentially hazardous food include: vegetables, potato salad, eggs, and dairy products. I am providing the following hot temperature control for the hot holding of all potentially hazardous foods above 135°F: I am providing an accurate probe thermometer to measure the hot and cold holding of potentially hazardous foods during all times of booth operation: Q^Yes No I am providing food that is NOT prepared at home: Yes 0 No All food is prepared,on-site or is from approved commercial facilities: 0 Yes No Name of facility: • Food Truck \Phone: ([ Address of facility: ____________________________________________