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TEMPORARY FOOD VENDOR’S APPLICATION <br />1 Name of Event:1. <br />2. <br />Address: <br />Phone <br />3. <br />4. <br />5. <br />6. <br />7. <br />the hot and cold holding of potentially hazardous <br />8. <br />9. <br />meats, tamales, cooked beans, rice, <br />vegetables, potato salad, eggs, and dairy products. <br />TEMP EMEHT APP <br />P»g«7 of Al <br />EHD 16-02 <br />(WO 1/16 <br /> Other (specify) <br />only operations not required to provide enclosed booths <br /> Stemo & hotel trays <br /> Steam table & lids <br /> Other (specify) <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 />MOUNTAIN HOUSE FARMERS MARKET <br />Note: The only operations not required to provide enclosed booths are those which sell beverages from <br />approved dispensers, or prepackaged foods from approved sources. <br />Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods: <br />Date(s): YEAR <br />ROUND <br /> Approved bottled water. <br /> On-site hose bib that is connected to a potable water source. <br />Q other (specify): <br />Electricity is provided for my booth's use: Yes Q No <br />I am providing an accurate probe thermometer to measure <br />foods during all times of booth operation: LI Yes Qd No <br />I am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br />135°F: <br />The following is information about my organization/business:^_ <br /> Name of organization/business: A/ 37/y <br /> ^6/A Acmes' Mw/o Mirk <br />(Alternate: ^52--------- <br /> List food to be sold or given to the Dublic:"^?^?^ <br />I am providing food that is NOT prepared at home: S Yes LJ No <br />All food is prepared on-site or is from approved commercial facilities:^ Yes LI No <br /> Name of facility: A, .^7 -------------------7 Ph°^ <br />Address of fanlity 57?^ .^ <7^ M ^251 <br />I am providing a booth with the following: (to protect my unpackaged food and food-preparation areas from flies, <br />dust and the public) <br />□SA booth with walls and ceiling constructed of either wood, canvas, plastic, similar matenal and fine mesh. fly <br />screening, completely enclosing open food areas. It will also have a smooth and fteanab'e*• <br />asphalt, clean tarps and smooth wood are acceptable) and constructed to separate food and food preparation <br />areas from the public. <br /> Camp stove <br /> Double steamer <br />E] Electric stove top <br />Note: Examples of potentially hazardous food ln^udo;