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-MW :MRC DOOGL- FAa< NO. :563 6707 Apr. 25 2005 0-:3:51M P. <br /> P O'B I'1388 -' c�a <br /> .4.Q3 E. 'Nehkr A••t3. FOt 1'l �C i L ;� / T <br /> 1J VENDOR'S S CHECKLIS 1 ,,»:r � <br /> - Y <br /> All food ltzdors(both fuHt� <br /> profit and nonpro fa) are required to rotum a signed and complc LLp copy uF dais Checklist <br /> to the festival orvanizer two 2) mm;hs pncr to this event_ Rcrnrn to: <br /> Eli in blank or check me appropriate to.(CS): TVQ-S jti-5 <br /> Yie�. <br /> 1. \ in <br /> ne and date of Event: <br /> 2. :'ae zme, address, and phone number of my organiaation/btsiness is: i'(S•>�. 64 �NS <br /> F-1 3. list food to be sold or given w the public: F.�(N <br /> 0 <br /> (D 4. Q3 1 am providing no foods which arc homemade. All toads are prepared on-site or:tom <br /> ,yt approved non-home and`o, comme:riai fatiiioes. <br /> H `tame of facility E. H permit .+ <br /> 1 am protecting my .mpockage;: food and food-preparation areas 7rom flies, dtni;t� and the public <br /> by the following methods; <br /> Q a booth with walls and ceiliug constructed of either wood, "vat, plastic, similar <br /> material, and fine mesh fly screening, completely enclosing open foal areas <br /> t [ a booth with a smooth acd cleanable floor (concwe;e, asphalt, Cie= tarps and smooth <br /> 'I wood are acceptable) <br /> f] a booth ootssmrcted to separate food and food preparation areas from the public <br /> D 7 other (specify): <br /> \OTE: 711 only operations not required to provide enclosed booths are those which sell <br /> heverages from approved dispeasers, or prepackaged foods from approved sources. <br /> 6. Approved water for daMkmg, utensil, and Sandwashing will be provided in my booth by the <br /> fodow)ng methods: <br /> ( I approved batted water (Alhambr, Polar,Sierra Spring, ctc.) <br /> ( ] base-bb onsite at :he -tsttiival <br /> D <br /> other (specify) tuYckl C7 <br /> 7- E:cetricty is provided for my booth's use. ( )yes pqno <br /> 3. [ ] Yes, I am providing an accurate probe thermometer to measure the Sot and cold hu.'ding <br /> ts� of potentially hazardous foods during all times of booth operation (55-57.00 at restaurant <br /> t' Supply stores). <br /> 9. [ am providing the following Som tem •r nuc convot for the :rpt holding of all po;en da if <br /> aa]lydous foods- above 140 F_ y <br /> I Camp stave I ) sterno & hent trays <br /> p ( 1 double steamer (I steam tabic & !ids <br /> [ I electric stave top ( 1 colter (specify) <br /> 'IJOTf': potentially hisardetrs feud eaucpies-meats, tamales.cooked beats.rice and vegetables, <br /> perato salad eggs and dairy producta, etc. <br /> Sac Reverse Side <br />