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SAN 10AQU 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: Autism Resources & Spring Festival Date(s): 4 1 12 1 2025 <br /> 2. The following is information about my organ izationlbusiness: <br /> Name of organ izationlbusiness: Oni urns LLC <br /> Address: 1778 Wellington Ave, Manteca CA 95337 <br /> Phone: (408 ) 476-2922 Alternate: ( ) <br /> 3. List food to be sold or given to the public: Fusion Onl in ^' <br /> 4. 1 am providing food that is NOT prepared at home: [?Yes ❑ No <br /> All food is prepared on-site or is from approved commercial facilities: SZYes ❑ No <br /> Name of facility: Tealite Modesto Phone: (408 )802 - 0258 <br /> Address of facility: 3848 McHenry Ave #120 Modesto, CA 95356 <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 /> WA 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 /> ❑ Other(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 /> ❑ On-site hose bib that is connected to a potable water source. <br /> ❑ Other(specify): <br /> 7. Electricity is provided for my booth's use: [ Yes ❑ No <br /> 8. 1 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 /> 9. 1 am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br /> 135°F: <br /> ❑ Camp stove ❑ Sterno& hotel trays <br /> ❑ Double steamer ❑ Steam table& lids <br /> ❑ Electric stove top 5;0bther(specify) Countertop Heated Display Case <br /> Note: Examples of potentially hazardous food include: meats, tamales, cooked beans, rice, <br /> vegetables, potato salad, eggs, and dairy products. <br /> 1868 E. Haxelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/ehd <br /> EHD 16-02 Page 7 of 11 TEMP EVENT APP <br /> 06/29/2023 <br />