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(84/i85 <br />Environmental Health Department <br />6-6-26 & 6-7-26 <br />Date(s): <br />1. Name of Event:1. <br />2. <br />Address: <br />)(Phone: <br />List food to be sold or given to the public:3. <br />4. <br />5. <br />6. <br />the hot and cold holding of potentially hazardous <br />9. <br />meats, tamales, cooked beans, rice, <br /> Sterno & hotel trays <br /> Steam table & lids <br />[■] Other (specify) <br />7. <br />8. <br />SAN JOAQUIN <br />-COUNTY- <br />)________________ _________ <br />Various Salads - Pork Belly - Bottled Sodas <br />Note: Examples of potentially hazardous food include: <br />vegetables, potato salad, eggs, and dairy products. <br />the festival coordinator three (3) weeks prior to this event. <br />Manteca Watermelon Street Fair <br />Name of organization/business: <br />142 Jason St <br />209-239-4182________ Alternate^ <br />TriTip, Chicken, and Linguica Sandwiches - Ribs - <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov_org/ehd <br />Onno 7 rxf 1 4 I cMr tVElN I ArrEHD 16-02 page 7 of 11 <br />06/19/19 <br />The following is information about my organization/business. <br />Fagundes Meats bbq food truck <br /> Approved bottled water. <br /> On-site hose bib that is connected to a potable water source. <br />fisi^u / AX Food TruckH Other (specify): ------------------------------- -------—-- --------- <br />Electricity is provided for my booth’s use: [■J Yes LJ No <br />I am providing an accurate probe thermometer to measure <br />foods during all times of booth operation: HJ 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 <br /> Double steamer <br /> Electric stove top <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 />I am providing food that is NOT prepared at home: ® 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 />e of farilitW 142 JaSOn St‘ ManteCa- CA 95330___________________________________________________________________ <br />fam providing a booth with the following: (to protect my unpackaged food and food-preparation areas from Wes. <br />dust and the public) <br />areas from the public. * ’ 1^ <br />„ , Mobile Food Kitchen G V^hy <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 />Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods: