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TEMPORARY FOOD VENDOR’S APPLICATION <br />1. <br />2. <br />Address: <br />Phone: <br />3. <br />4. <br />5. <br />!_| Other (specify): <br />6. <br />9. <br />meats, tamales, cooked beans, rice, <br />7. <br />8. <br />-7; CrC <br />TEMP EVENT APR <br />05 | ' 209 ’ F 20? <br />Page 7 of 11 <br />_________________ <br />Alternate: (« <br />Name of organization/business: <br /><£io) <br />List food to be sold or given to the public: <br />The following is information about my organization/business: <br />THAH U <br />required to return a signed and completed copy of this checklist to <br /> Date(s):. <br />All food vendors (both for profit and non-profit) are ’ <br />the festival coordinator three (3) weeks prior to this event <br />1. Name of Event: HOhHTMH Ctyl <br />:3€? E. i-ia <br />EHD 16-Q2 <br />0*29.2023 <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 />SJ Approved bottled water. <br />O On-site hose bib that is connected to a potable water source. <br /> Other (specify):____ ____________ <br />Electricity is provided for my booth's use: YesTJ-No -------------------------- <br />I am providing an accurate probe thermometer to measure the hot and cold holding of potentially hazardous <br />ioods during all times of booth operation: [2 Yes No <br />I am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br />y13o°F: <br />[S Camp stove Stemo & hotel trays <br /> Double steamer Q Steam table & lids <br /> Electric stove top SkOther (specify) j <br />Note: Examples of potentially hazardous food include: <br />vegetables, potato salad, eggs, and dairy products. <br />'/am providing food that is NOT prepared at home: Yes No <br />All food is prepared on-site or is from approved commercial facilities: Yes No <br />Name of facility: ' Phone: ( ) <br />Address of facility: P-O-X ‘ <br />1 the public? f0,,°W'n9: (t° proteCt unPackage<i tod and food-preparation areas from flies, <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 />aX^fromthe pubfic^ SmO°th W00d 3re accePtable) and constructed to separate food and food preparation