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AOUIN <br />TEMPORARY FOOD VENDOR’S APPLICATION <br />Date(s): <br />2. <br />?</3 <br />Address: <br />Phone: <br />3. <br />4. <br />5. <br />6. <br />9. <br />meats, tamales, cooked beans, rice, <br />5 <br />7. <br />8. <br />TEMP EVENT APP <br />AH j: <br />Alternate: (*50) Y...)b / 3 <br />List food to be sold or given to the public: <br />required to return a signed and completed copy of this checklist to <br />l)am providing food that is NOT prepared at hom^£j Yes No <br />All food is prepared on-site or is from approved commercial facilities: Yes No <br />Name of facility: kV phono: <br />Address of facility: ’ <br />' T.Sh a b^’1!1 Wifh ttle fo"owin9: ((0 protect my unpackaged food and food-preparation areas from ffe <br />uu>r ano rne public) <br />All food vendors (both for profit and non-profit) are i_,J.. <br />the festival coordinator three (3) weeks prior to this event. <br />1.1. Name of Event: <br />The following is information about my organization/business: <br />Name of organization/business: y-4 /er C <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 />’pEl Approved bottled water. <br /> On-site hose bib that is connected to a potable water source. <br /> Other (specify): <br />Electricity is provided for my booth's use: Yes <br />foods during all times of booth operation: <br />I am providing the following hot temperatui <br />135T: <br />(3''Camp stove <br />O Double steamer <br /> Electric stove top <br />I E. HaxcUon | .S'tv-l.-.un :?52ri5 | r ?nc> 1 ••• i a.' <br />. - j LatNo r7~ <br />am providing an accurate probe thermometer fo measure the hot and cold holfltag of potentially hazardous <br />i: El Yes No <’ • <br />jpecontrol for the hot holding of all potentially hazardous foods above <br /> Sterno & hotel trays <br /> Steam table & lids <br /> Other (specify) <br />Note: Examples of potentially hazardous food include: <br />vegetables, potato salad, eggs, and dairy products. <br />2^"’,±„fo±and 1Cei1lin9 const?,c'ed °'either wood. cam^. similar material and fine mesh fly <br />9i t0™pletely ^closing open food areas. It will also have a smooth and cleanable floor (concretey <br />areas mm7he Sir S'T,octh woori are acceptable) and constructed to separate food and food preparation <br /><31 Cub HUill lilt* pUUlfCz. <br /> Other (specify):