COMPLIANCE INFO - Laserfiche WebLink

Home Browse Search

i 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.NameofEvent: NlotliTAIN kouSe 'foo4-r"rV fpDA15 Date(s):Mk" M41 i 2. The following Is Information about my organ lzation/busl ness: Name of organization/business:JL, CgRAW 1"11�Cv 1_000 i Address: _3111 CAP-MsL W14-Y SAt.s {,0-ANPV-0 C,+A Ali � I Phone: (A%5)_ IS6-0 SI Alternate: (ojt r ) 6011 S--0 3. List food to be sold or given to the public: M1rXtG4N -f o 9 /-H4 uoS,1,V ILPToS N oS, BoW t,5 4. 1 am providing food that is NOT prepared at home:RI Yes 0 No , All food Is prepared on-site or is from approved commercial facilities:Q Yes[] No Name of facility: Phone: Address of facility: I 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 1 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 i areas from the public. '/ Other(specify): �u CK Note: The only operations not requlr provide enclosed booths are those which sell beverages from approved dispensers,or prepackaged foods from approved sources. i 6. Approved water for drinking,utensil and hand washing will be provided in my booth by the following methods: VT Approved bottled water. ❑On-site hose bib that is connected to a potable water source. l Other(specify): 7. Electricity is provided for my booth's use: Yes No 6. 1 am providing an accurate probe thermometer to measure the hot and cold holding of potentially hazardous =. foods during all times of booth operation: fO Yes❑No 9. 1 am providing the following hot temperature control for the hot holding of all potentially hazardous foods above 1 135°F: -y r" ❑Camp stove ❑Sterno&hotel trays '� ❑Double steamer N Steam table&lids ❑ Electric stove top ❑Other(specify) P" Note: Examples of potentially hazardous food Include: meats, tamales, cooked beans, rice, vegetables,potato salad, eggs,and dairy products. I i EHO 1e-02 Pnge 7 of 11 TEMP EVENT APP 05/01/18 J i