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TEMPORARY FOOD VENDOR’S APPLICATION 1.Date(s): 3/15/19 2. Address: 3. 4. 5. 6. 7. 8.the hot and cold holding of potentially hazardous 9. meats, tamales, cooked beans, rice, Page 7 of 11 TEMP EVENT APP On-site hose bib that is connected to a potable water source. Other (specify): Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods: KJ Approved bottled water. Electricity is provided for my booth’s use: The following is information about my organization/business: Name of organization/business: ENe S Custom Catering, LLC 4719 Quail Lakes Drive PMB 250 Stockton, CA 95207 Phone: (299 )~ Alternate: ( ) □st food to be sold or given to the public: pO 11 d. C [£S , p \j )?<C' 0 h '^S"C pQfcl Note: The only operations not required to provide enclosed booths are those which sell beverages from approved dispensers, or prepackaged foods from approved sources. 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 of facility: Wod \ A UA Phone: MH' Address of facility: H5S. S>C^Oo\ SHypH? ; I—0<A\ C-fV______________________ 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. E other (specify): Grand Theatre - Kitchen Camp stove Q Stemo & hotel trays Double steamer Q steam table & lids Electric stove top Q other (specify) Note: Examples of potentially hazardous food include: vegetables, potato salad, eggs, and dairy products. 7/28/10 Yes No I am providing an accurate probe thermometer to measure foods during all times of booth operation: EjYes No 1 PJ°vidin9 folkwing hot temperature control for the hot holding of all potentially hazardous foods above loo r. 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 1. Name of Event Girls Night Out - Bubbly, Boots & Bling