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R EC-008 <br /> S A N I4J 0 A Q U IN Environmental (Health Department , <br /> f �'•:_ : —COUNTY- <br /> 1) ss grows here, <br /> TEMPORARY FOOD VENDOR'S APPLICATION <br /> All lood vendors (both for profit and non-proff) are required to return a signed and completed copy of this checldfsl to <br /> the festival coordinator three(3)weeks prior to this event. <br /> 1. 1.Name of Event I Juneteenth, MIP Cultural Celebration Dates? 6/15/24 <br /> 2. The following Is Information about my organization/buslness 1/24 <br /> Name of organ Izallon/business: RAYS FLAVOR OF INDIA <br /> 1 <br /> Address: 71 CHARLES ST TRACY CA 95376 <br /> Phone: 408-821-6108 Alternate: 209"362-6690 <br /> i <br /> 3, List food to be sold or given to the public: INDIAN STREET FOOD AND DRINKS <br /> i <br /> i <br /> 4. 1 am providing food that is !QT prepared at home: ✓kes 0 <br /> All food Is prepared on-site or is from approved commercial facllltles:D0 ✓�lo ' <br /> Name of facility: Phone: <br /> i <br /> Address of facility:PREPARE FOOD ON SITE i <br /> 5, 1 am providing a booth with the following:(to protect my unpackaged food and food-preparation areas from Ilfes, <br /> dust and the public) j <br /> F/ booth with walls and ceiling constructed of eliher wood, canvas, plastic, similar material and fine mesh fly i <br /> ening, 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 /> 11ther(specify): <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 /> Ej)n-site hose bib that Is connected to a potable water source. <br /> her(specify): <br /> 7. Peoirloity Is provided for my booth's use Ye' <br /> e V No i I <br /> 8, 1 am providing an accurate probe then asure the hot and cold holding of potentially hazardous <br /> loodsduring all times of booth operation Ye o <br /> 9. lam providing the lollowing'ho1 temperalu nlro o the hot holding of all potentially hazardous foods above <br /> 5°F_ <br /> ,amp stove Steao& hotel trays <br /> oublo steamer Stearn table&lids <br /> (eclrlc stove top Other(specify) <br /> Note: Examples of potentially hazardous food Include: meals, tamales, cooked beans, rice, <br /> vegetables,potato salad,eggs,and dairy products. <br /> 1868 E, Hazellon Avenue I Stockton,California 96205 I T 209 468.34201 F 209 464.0138 1 www.sigov.org/ehd <br /> EHD I6.02 Pago7of f1 TEIAP EVENT APP <br /> 06119119 <br />