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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 Manteca Pumpkin Festival Date(s), 1016- 1017 <br /> 2. The following is information about my organizationibusiness: <br /> Name of organ izationlbusiness: Double Dippin <br /> Address: 113 west G 5t 9303 <br /> Phone: ( ) 6198656234 Alternate: ( ) <br /> 3. List food to be sold or given to the public: 25 different amazing gourmet dips <br /> 4 1 am providing food that is NOT prepared at home: ❑Yes F71 No <br /> All food is prepared on-site or is from approved commercial facilities: R/ Yes❑ No <br /> Name of facility: Asenzya lnc Phone: <br /> Address of facility: 7616 5 6h St Oak Creek Wt 53154 <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 /> 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): See booth pits <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 foibwing methods <br /> ❑J Approved Mottled water. <br /> ❑On-site hose bib that is connected to a potable water source. <br /> ❑ Other(specify): <br /> 7 Electricity is provided for my booth's use: ❑ Yes❑J No <br /> 8 t am providing an accurate probe therrwmeter to measure the hot and cold holding of potentially hazardous <br /> foods during all times of booth operation: Q Yes❑ No <br /> 9. 1 am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br /> 1359FL <br /> ❑Camp stove ❑ Stemo&hotel trays <br /> ❑ Double steamer [] Steam table&lids <br /> n 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 /> COMPLETE BOTH SIDES AND RETURN WITH EXHIBITOR AGREEMENT <br />