Laserfiche WebLink
' l <br /> } i <br /> a <br /> TEMPORARY FOOD VENDOR'S APPLICATION <br /> I <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 Even: 1 Date(s): kc)).= lip <br /> i <br /> 2. The following Is information about my organization/business: <br /> �•p i <br /> Name of organi/zationlbusFiness:` >1A -"I <br /> r <br /> Address: 7( ( �1tLt Tl4lf�ii+wiz[�L, e� 9�� <br /> Phone: ( W 1 Alternate:{ ) <br /> 3. List food to be sold or given to the public: A 4, A! i <br /> 4. 1 am providing food that is NOT prepared at home: Yes❑No <br /> All food is prepared -site or is from approved commerclat facilities:p'Yes❑ No <br /> Name of facility: ar& Phone:gi KO) � <br /> Address of facility: W , OW 7001 <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) 3 <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. 6 <br /> - E <br /> ❑Other(specify): <br /> ) 1 <br /> Note: The only operations not required to provide enclosed booths are those which sell beverages from I <br /> approved dispensers,or prepackaged foods from approved sources. E <br /> 8. Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods: <br /> ❑Approved bottled water. <br /> s❑On-site hose bib that is connected to a potable water source. 1 <br /> �ther(specify): ' 9- a W&IVvC <br /> 3 <br /> 7. Electricity is provided for my booth's use:VY s❑No <br /> �E <br /> 8. 1 am providing an accurate probe thermometer o measure the hot and cold holding of potentially hazardous <br /> foods during all times of booth operation:®Yes❑No <br /> 9. 1 am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br /> 135°I=: <br /> ❑Camp stove Vsteam <br /> emo&hotel frays <br /> El Double steamer table&lids <br /> ❑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 /> EH❑16,02 Page 7 of 11 TEMP EVENTAPP ; <br /> 7/14/15 <br /> t <br />