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TEMPORARY FOOD VENDOR'S APPLICATION <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 Event: 'Wni C'lOt'nrC ,* u Date(s): � <br /> 2. The following is information about my organ izationlbusiness: <br /> Name of organization/business: <br /> Address: _ 1;_6 )I(AU(t '(I 4�� <br /> Phone: 71(o ,_9�209-7� ----- Alternate: ( ) <br /> 3. List food to be sold or given to the public: <br /> 4. 1 am providing food that is NOT prepared at home-KYes Q No <br /> All food is prepared on-site or is from approved commercial facilities:WYes ❑l No <br /> Name of facility: Phone: l� 902— 09 <br /> Address of facility: -( <br /> 5. 1 am providing a booth with the following: (t-)protect my unpackaged food and food-preparation areas from flies, <br /> dust and the public) <br /> ,R�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. <br /> ❑Other(specify): <br /> Note: The only operations not required to provide enclosed booths are those which sell beverages front <br /> approved dispensers, or prepackaged foods from approved sources. <br /> 6. Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods: <br /> Approved bottled water. <br /> On-site hose bib that is connected to a potable water source. <br /> ❑ Other(specify): <br /> 7. Electricity is provided for my booth's use: Yes ❑ No <br /> 8. 1 am providing an accurate probe thermometer to 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°F: <br /> ❑Camp stove ❑ Sterno&hotel trays <br /> ,® Double steamer JWSteam 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 /> EHD 16-02 Page 7 c.t 11 TEMP EVENT APP <br /> 06/19/19 <br />