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R EC-008 <br /> S A N J O A Q U I N Environmental Health Department <br /> COUNTY <br /> 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: Music in the F _Date(s): 4 <br /> 2. The following is information about my organization/business: <br /> Name of organization/business: Los Primos Tex-Mex Food LLC <br /> Address: 2471 North Naglee Road Suite 100 #1030 <br /> Phone: 773-708-1214 Alternate: 209-884-0191 <br /> 3. List food to be sold or given to the public: Tacos, Burritos, Fries, Nachos, Quesadillas <br /> 4. 1 am providing food that is NOT prepared at home:16esDl0 <br /> All food is prepared on-site or is from approved commercial facilities: ✓6es[jNo <br /> Name of tacility: Commissary Modesto _Phone: 209-362-9123 <br /> Address of facility:1211 S 7th Street <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 /> Je <br /> booth with walls and ceiling constructed of either wood, canvas, plastic, similar material and fine mesh fly <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 /> WfAther(specify): Food Truck <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 /> Dn-site hose bib that is connected to a potable water source. <br /> W/ ther(specify): Food Truck Waters stem <br /> 7. se �/ Ye ectricity is provided for my booth's u No <br /> 8. 1 am providing an accurate probe the tC' <br /> asure the hot and cold holding of potentially hazardous <br /> foods during all times of booth operation o <br /> 9. 1 am providing the following hot temperature conlrotTo-jr the hot holding of all potentially hazardous foods above <br /> q5°F: <br /> amp stove Sterno& hotel trays <br /> V( ouble steamer Steam table &lids <br /> lectric 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 /> 1868 E. Hazelton Avenue I Stockton,California 95205 1 T 209 468-3420 1 F 209 464-0138 i www.sjgov.org/ehd <br /> EHD 16-02 Page 7 of 11 TEMP EVENT APP <br /> 06119119 <br />