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Environmental Health Department <br />1.1, Name of Event: Escalon farmers market Date(s): <br />2.The following is information about my organization/business: <br />Name of organization/business: Birria Fuego <br />Address:560 L.edw'th Ct, Turlock CA 95382 <br />Phone:). 677-5298 Alternate: () <br />3.List food to be sold or given to the public: QuesaTacos, quesabirria, birria ramen, birria nachos, keto tacos, <br />4. <br />i <br />5. <br /> Other (specify): <br />Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods:6. <br />.pproved bottled water. <br /> On-site hose bib that is connected to a potable water source. <br />9. <br />meats, tamales, cooked beans, rice, <br />7. <br />8. <br /> Sterno & hotel trays <br /> Steam table & lids <br /> Other (specify) <br />Yes No x <br />^scial facilities G Yes No <br />Phone: (___ <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 />Note: Examples of potentially hazardous food include: <br />vegetables, potato salad, eggs, and dairy products. <br />( 209 <br /> Other (specify): ,______________________________________ <br />Electricity is provided for my booth’s use: Yes LONo <br />I am providing an accurate probe thermometer to nieasure the hot and cold holding of potentially hazardous <br />foods during all times of booth operation!r—''' <br />I am providing the following hot temperature <br />\135°F: <br />LJ Camp stove <br /> Double steamer <br /> Electric stove top <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 />isPLYes No <br />ir^wntrol for the hot holding of all potentially hazardous foods above <br />1 am providing food that is NOT prepared at home:\Z <br />All food is prepared on-site or is from approved commi <br />Name of facility: <br />Address of facility: <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 />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjcehd.com <br />EHD 16-02 Page 7 of 11 TEMP EVENT APP <br />07/3/17 <br />©sA 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 />, SAN JOAQUIN <br />' HU'.? ----COUNTY----- <br />'<(, Gr<>nfness 9/0tvs here. <br />TEMPORARY FOOD VENDOR’S APPLICATION