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---y <br />SAN JOAQUIN Environmental Health Department <br />TEMPORARY FOOD VENDOR’S APPLICATION <br />1 Name of Event1 <br />2 <br />Address: <br />209 <br />3 <br />4 <br />5 <br />[X Other (specify): <br />Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods:6 <br /> Approved bottled water. <br />9. <br />meats, tamales, cooked beans, rice, <br />7. <br />8. <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 /> Sterno & hotel trays <br />K Steam table & lids <br /> Other (specify) <br />1868 E Hazelton Avenue i Stockton California 95205 ■ T 209 468-3420 1 F 209 464-0138 • www sjcehd com <br />EHD 16-02 Page 7 of 11 TEMP EVENT APP <br />07/3/17 <br />The following is information about my organization/business: <br />Name of organization/business: Flip N Fry Mobile Catering LLC <br />3933 Shady Oak Ct, Turlock, CA 95382 <br />Note: Examples of potentially hazardous food include: <br />vegetables, potato salad, eggs, and dairy products. <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 />Red White & Brew Wine and Beerfest <br />foods during all times of booth operation K Yes I 1 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 /> 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 />Enclosed mobile food facility - trailer <br />nat^Mar 23, 2024 <br />Phone: ( ) 277-6248 Alternate: ( ) <br />List food to be sold or given to the public: Burgers, Fries, Loaded Fries, Hot Dogs, <br />can soda, bottle water <br />I am providing food that is NOT prepared at home: [5^ Yes No <br />All food is prepared on-site or is from approved commercial facilities: K Yes Q No <br />Name of facility: La Comisaria Phone: (209 >338-3663 <br />Address of facility: 1211 S 7th St, Modesto, CA 95351 <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 />Q On-site hose bib that is connected to a potable water source. <br />Other (specify): potable water tank <br />Electricity is provided for my booth's use. Yes X No <br />I am providing an accurate probe thermometer to measure the hot and cold holding of potentially hazardous