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SAN JOAQUIN Environmental Health Department TEMPORARY FOOD VENDOR’S APPLICATION 3/29/2025 Date(s):I.Name of Event: Red white and brew1. The following is information about my organization/business2. Address 510-363-7616 ) Phone:) ( 3. 4. 5. Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods:6. Approved bottled water. On-site hose bib that is connected to a potable water source. •ter to measure the hot and cold holding of potentially hazardous 9 meats, tamales, cooked beans, rice, I otcsk' Page 7 of 11 7 8 □Other (specify): Note: The only operations not required to provide enclosed booths are those which sell beverages from approved dispensers, or prepackaged foods from approved sources. -wv siqo. nrg.ar.d TEMP EVENT APP Name of organization/busirfife^ h'its the streets 295 Bonner drive Mountain house ca 95391 Note: Examples of potentially hazardous food include: vegetables, potato salad, eggs, and dairy products. All food vendors (both for profit and non-profit) are required to return a signed and completed copy of this checklist to the festival coordinator three (3) weeks prior to this event. 1358 t EHO 1602 06*29/2023 Other (specify):Hand wash sink in fQQd truck Electricity is provided for my booth's use: Yes QNo I am providing an accurate probe thermometer to measi „ foods during all times of booth operation: Yes No I am providing the following hot temperature control for the hot holding of all potentially hazardous foods above 135°F: Camp stove Double steamer Electric stove top Alternate: ( , „ Hawaiian poke and acai List food to be sold or given to the public: I am providing food that is NOT prepared at home: Yes No All food is prepared on-site or is from approved commercial facilities^ Yes No Name offacilit/-1'5 l-LC...........................................................Phone*?9-331)-3663-------------------------------- 1211 S / street Address of facility: Modesto ca 95351 ___________:— I am providing a booth with the following: (to protect my unpackaged food and food-preparation areas from flies, dust and the public) A booth with walls and ceiling constructed of either wood, canvas, plastic, similar material and fine mesh fly screening, completely enclosing open food areas. It will also have a smooth and cleanable floor (concrete, asphalt, clean tarps and smooth wood are acceptable) and constructed to separate food and food preparation areas from the public. permitted food truck in san jaoquin Sterno & hotel trays Steam table & lids Other (specify) only cold food and rice warmer