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30^^ <br />< <br />Environmental Health Department <br />Dec 6. 20251Date(s). <br />2 <br />Address. <br />Phone:( <br />3 List food to be sold or given to the public. <br />4 <br />-.4/. 4 <br />5 <br />[■] Other (specify) <br />6 <br />9 <br />meats, tamales, cooked beans, rice. <br />7 <br />8 <br />Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods <br /> Approved bottled water. <br />____________ Alternate: ( )__________ <br />Trl-Tip, Chicken, and Llnguica Sandwiches Ribs - Various Sides - Pork Belly - Bottled Sodas <br />1368 E Hazelton Avenue I Stockton. California 95205 | T 209 468-3420) F 209 464-0138 | www sjgov org/ehd <br />EHD 16-02 Page 7 Of 11 TEMP EVENT AP» <br />06/19'19 <br /> On-site hose bib that is connected to a potable water source. <br />[■] Other (specify): TfUCk _________________________________________ <br />Electricity is provided for my booth's use. B] Yes No <br />I am providing an accurate probe thermometer to measure the hot and cold holding of potentially hazardous <br />foods during all times of booth operation: [■] Yes No <br />I am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br />135°F <br />O Camp stove Sterno & hotel trays <br /> Double steamer Steam table & lids <br /> Electric stove top [■] Other (specify) <br />Note: Examples of potentially hazardous food include: <br />vegetables, potato salad, eggs, and dairy products. <br />SAN JOAQUIN <br />- 1 I i f- J ' — <br />..1 /•,!» i*^r, <br />TEMPORARY FOOD VENDOR’S APPLICATION <br />I am providing food that is NOT prepared at home: H Yes No <br />All food is prepared on-site or is from approved commercial facilities: [■) Yes No <br />Name of facility Eagundes Meats phone. > <br />Address of facility: 14? -Jason St. Manteca. CA 95330 <br />I am providing a booth with the following (to protect my unpackaged food and food-preparation areas from flies, <br />dust and the public) <br />Fl A booth with walls and ceiling constructed of either wood, canvas, plastic, similar material and fine mesh fly <br />screening, 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 />Mobile Food Kitchen 'j/rs/l L S TC - <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 />The following is information about my organization/business. <br />Name of orgamzation/busmess: MegtS bbC| food truck <br />142 Jason St <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 Name of Event Manteca Chamber Christmas in the park <br />} 209-239-4182