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Must be returned <br />TEMPORARY FOOD VENDOR'S APPLICATION <br />October 4-5, 25Date(s):I.Name of Event:1. <br />2. <br />Name of organization/business: <br />680 Town SQAddress <br />510-304-9350 Alternate: (Phone <br />Mini Donuts,List food to be sold or given to the public.3 <br />4 <br />5 <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 />0 On-site hose bib that 1 s connected to a potable water source. <br />0 Other (specify): <br />7 <br />8 <br />9 <br />N/a for us <br />meats, tamales, cooked beans, rice, <br />TEMP EVENT APPPage 7 of 11EHO 1602 <br />08 01 16 <br />0 Camp stove <br />0 Double steamer <br />0 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 />0 Sterno & hotel trays <br />0 Steam table & lids <br />Other (specify) <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 />J®Ca 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 />0 Other (specify)_____ __________________________________________ <br />The following 1s information about my organization/business: <br />Nana Bear's Mini Donuts <br />© <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 />Manteca Pumkin Fair <br />I am providing food that is NOT prepared at home:)^ Yes O No <br />All food is prepared on-site or is from approved commercial facilities Yes O No <br />Name of facility N/a for us Phone <br />Address offacility:____________________________________________ <br />Note: Examples of potentially hazardous food include: <br />vegetables, potato salad, eggs, and dairy products. <br />Electricity 1s provided for my booth's use $^es O 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 O Yes No <br />I am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br />135F: