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f <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 /> the festival coordinator three(3)weeks prior to this event. <br /> 1. 1.Name of Event: Stockton Tequila Festival Dates; 10/20/2018 <br /> 2. The following is information about my organization/business: <br /> Name of organizationfbusiness: SMA Entertainment. LLC U/ <br /> Address: 1615 Kyburz Ct., Stockton, CA, 95206 <br /> Phone: (209) 464- 5223 Alternate: ! ) <br /> 3 Lst food to be sold or given to tie puY.i_: Lemonade, Fruit Cups <br /> 4. 1 am providing food that is NOT prepared at home: ❑Yes IN No <br /> All food is prepared on-site or is from approved commercial facilities:❑Yes❑No <br /> Name of facility: Phone:( 1 <br /> Address of facility: <br /> 5. 1 am providing a booth with the following:(to protect my unpackaged food and food-preparation areas from flies, <br /> dust and the public) <br /> 09 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 /> ❑Other(specify): <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 /> 6. Approved water for drinking,utensil and hand washing will be provided in my booth by the following methods: <br /> X)Approved bottled water. <br /> ❑On-site hose bib that is connected to a potable water source. <br /> ❑Other(specify): <br /> Electricity is provided for my booth's use:g'Yes❑ 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:?]Yes❑No <br /> 9. 1 am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br /> 135°F: <br /> ❑Camp stove ❑Sterno&hotel trays <br /> ❑Double steamer ❑Steam table&lids <br /> ❑Electric stove top ❑Other(specify) <br /> Note: Examples of potentially hazardous food include: meats, tamales, cooked beans, rice, <br /> vegetables,potato salad,eggs,and dairy products. <br /> EHD 1E-02 Page 7 of 11 TEWIP EVENT APP <br /> 11'4114 <br />