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TEMPORARY FOOD VENDOR'S APPLICATION <br /> and r�OR)are required tc return a signed aril cornpfeted c�Y LI tuts checktrst to <br /> All food vendors(botft for prt�it the festival aoor*nator three(3)weeks Prior to tttis ever; <br /> DBMS) <br /> 1 Name of Event Pupkin Fair m 8/7-818 <br /> 2 The"bwmq ts rforrnatrnn about rnt'orwilli adoNbusinm <br /> "arm of organrzation1buarrtess Sandees Fres <br /> Address. 645ODgughcr 7Rd# Dublin A <br /> Phone t 510?�. <br /> 40 -8100 Atrem"rte f ) <br /> 3 List food to be sold or given to the public. Please see <br /> a i am pmvrdtng food that re NOT prepared at home M Yes C No <br /> All food is prepared on-site or i%from approved axlr`nerc�W fat�lK�et M Yes❑No <br /> Name of facilrty. Costco Rhone: �09 8 - <br /> Address of fec+dkty St Manteca CA 95336-6745 _-- <br /> 5 1 am providing a booth with the toilo Mng. (to Protect my unpack99ed fond and food-preparation areas from flies <br /> dust and the public) <br /> ❑A booth with watts and ceiling consMx;tad of either woodr canvas. plastic similar material and fine mesh fly <br /> screening. compielety encimng open tood areas It wits also nave a smooth and cleanable floor dco <br /> asphatt dean tarps and smooth wood are acceptable? and constructed to separate food and food preparation <br /> areas from the out 4tc <br /> [g Other(spa ty). Food Trailer <br /> Kota: The onYy operations not required to provrDe ancSose4 booths are those whr- sell bent rag ea from <br /> approved dispensers of prepa(kagbd foods from approved sources <br /> 6 Approved water for drinking, utensli and hand washing wild be prnvrtlad in my booth by the fo*3wng methods <br /> L]Approved bottled water <br /> jL,on-sate rtose bib t"t IS connected to a potaule watui SUIJrCC <br /> Other(sW^) -- <br /> 7 Eiecli icity is provided for my booth 5 Use i_' Yes IX No <br /> 9 i am provrdff-vg an aoc:urate promihermorne6er to measure the hot and cold haidmg of WerTfiatty hazardous <br /> foods ounng a tsrles of booth aperabor- X� Yes f' Nr: <br /> 9 am providing the fdlowing hot temperature control for the not no►drng at ail potentialty hazardous foods above <br /> 1,35'F <br /> Camp move Lj Stemo 8 hotel bays <br /> Double steamer ❑Steam table& lids <br /> L Eiectnc stove M L2 Other(spm;d <br /> Note. Examp" of potentally nazarduius food include: mBata, tamales, cooked beans, rice, <br /> veggtabtt s, potato salad. eggs. and dairy products. <br /> TFMP EVENT APP <br /> Ear]'2oi <br />