Laserfiche WebLink
REC-008 <br /> SAN,JQAQUIN Environmental Health Department <br /> COUNTY <br /> Greatness grn,tis h.^rc. <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 05178/2 pale(s) .024 <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 Altemale: 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 lood that is NOT prepared a1 homer✓ YesDlo <br /> All food is prepared on-site or is from approved commercial facilities: ✓]YeC:]No <br /> Name of facility: Commissary Modesto Phone: 209-362-9123 <br /> Address of facility:121 1 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 /> 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. CAD <br /> R�ther(sp ify): Food 'S`{ —7 <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 10 a potable water source. <br /> Peciri <br /> ther(specify): Food Truck Waters stem <br /> 7, city is provided for my booth's use &/ Ye No <br /> B. I am providing an accurate probe the asure the hot and cold holding of potentially hazardous <br /> foods during all times of booth operation ✓ Ye o <br /> 9. 1 am providing the following hot lemperalu ntr the hot holding of all potentially hazardous foods above <br /> q5'F: <br /> jamp slove Slerno& hotel trays <br /> ✓ ouble steamer Sleam 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. Wazelton Avenue i Stockton,California 95205 i T 209 468-3420 i F 209 464-0138 1 www.sjgov.org/ehd <br /> FHD 16.02 Page 7 of 11 TEMP FVFNT APP <br /> 06119I19 <br />