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S A N J Uf.I U U ( 1V TEMPORARY FOOD VENDOR'S APPLICATION 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. 1.Nameof Event: MOPS &GOBLINS BREW FET Date(s)OCTOBER 28,2023 2. The following is information about my organization/business: Name of organization/business: Flip N Fry Mobile Catering LLC Y_ Address: 3933 Shady Oak Ct,Turlock, CA 95382 Phone: ( 209 ) 277-6248 ^_ _ Alternate: 3. List food to be sold or given to the public: Burgers, Fries, Philly Cheesesteaks, _ can soda,bottle water 4. 1 am providing food that is NOT prepared at horne:[9 Yes❑No All food is prepared on-site or is from approved commercial facilities:IM Yes❑No Name of facility: La Comisaria .Phone: (209 )338-3663 Address of facility: 1211 S 7th St,Modesto, CA 95351 5. 1 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. [N Other(specify): Enclosed mobile food facility_trailer Note: The only operations not required to provide enclosed booths are those which sell beverages frorn approved dispensers,or prepackaged foods from approved sources. & Approved water for drinking,utensil and hand washing will be provided in my booth by the following methods: ❑Approved bottled water ❑On-site hose bib that is connected to a potable water source. ®Other(specify): potable water tank T Electricity is provided for my booth's use:❑ Yes 91 No 8. 1 am providing an accurate probe thermometer to measure the hot and cold holding of potentially hazardous foods during all times of booth operation:®Yes❑No 9. 1 am providing the following hot temperature control for the hot holding of all potentially hazardous foods above 135°F: ❑camp stove ❑Sterno&hotel trays ❑Double steamer ®Steam table&lids ❑Electric stove top ❑Other(specify) Note: Examples of potentially hazardous food include: meats, tarnales, cooked beans, rice, vegetables,potato salad,eggs,and dairy products. T LHU 16-0;e Pop 7 of 11 TEMP EVENT APP 01 3%1 i