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required to return a signed and completed copy of this checklist to <br />1. <br />2. <br />Address: <br />Phone:( <br />3.List food to be sold or given to the public: <br />4. <br />5. <br />those which sell beverages from <br />6. <br />9. <br />meats, tamales, cooked beans, rice, <br />7. <br />8. <br />Environmental Health DepartmentSANJOAOUIN <br />— COUNTY----- <br />(j/cmn<'\s here. <br />TEMPORARY FOOD VENDOR’S APPLICATION <br />Note: The only operations not required to provide enclosed booths are <br />approved dispensers, or prepackaged foods from approved sources. <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 />TiiTIp, Chicken, and Llnguica Sandwiches - Ribs - Various Salads - Pork Belly - Bottled Sodas <br />The following is information about my organization/business: <br />Name of organization/business: ^^CJUndOS Meats bbC] food truck <br />142 Jason St <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 I www sjqov orq/ehd <br />O^fg02 Page 7 of 11 'lEMP EVENT APP <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: Fagundes Meats Phone: ( ) <br />Address of facility:142 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 /> Date(S): 6-7-25 & 6-8-25 <br /> 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 />■ other (specify): Mobile Food Kitchen <br />El On-site hose bib that is connected to a potable water source. <br />[■] Other (specify): _F00d_TTUCk___________________ _____________ ___ _____ _____________ <br />Electricity is provided for my booth’s use: [■] 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: (9 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 /> Camp stove Stemo & 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 />) 209-239-4182 <br />All food vendors (both for profit and non-profit) are i , ' ' <br />the festival coordinator three (3) weeks prior to this event. <br />1.Name of Event: Manteca Watermelon Street Fair