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FOOD VENDORS PERMIT 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 organizer two(2) months prior to this event. 1. Name of Event: Fk.MCraKE 5Q_tau.F4s'j Date(s): Ju!.l 4, Zoo4 2. The following is information about my organization/business: Name of organization/business: + fINI'S CuWe6 or- GZC- G_C_ LICA' Address: P 0• 5ai, -7(�I Phone: ( Zoc) ) 369 -3 0 0 o Alternate: (209 3. List food to be sold or given to the public: 5,au5&Ga uic.� Gu 4. 1 am providing foods that are not homemade: N Yes❑ No All foods are prepared on-site or are from approved commercial facilities: 9 Yes ❑ No Name of facility: Phone: ( ) E.H. Permit#: 5. 1 am protecting my unpackaged food and food-preparation areas from flies, dust and the public by the following methods: ® A booth with walls and ceiling constructed of either wood, canvas, plastic, similar material and fine mesh fly screening,completely enclosing open food areas. ❑A booth with a smooth and cleanable floor(concrete, asphalt, clean tarps and smooth wood are acceptable). ❑A booth constructed to separate food and food preparation areas from the public. ❑ Other(specify): Note: The only operations not required to provide enclosed booths are those, which sell beverages from approved dispensers, or prepackaged foods from approved sources. 6. Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods: ❑Approved bottled water(Alhambra, Polar, Sierra Spring, etc). Hose-bib on-site at the festival. ❑ Other(specify): 7. Electricity is provided for my booth's use: ❑Yes S No KcrC 4F_S- W S. 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 140°F: ❑ Camp stove ❑ Sterno&hotel trays ❑ Double steamer (24 Team table& lids ❑ Electric stove top ❑ Other (specify) Note: Potentially hazardous food examples: meats, tamales, cooked beans, rice, vegetables, potato salad, eggs and dairy products. FHD-16-02-002 Page 7 of 9 TEMP EVENT APP Bl712003