Laserfiche WebLink
TEMPORARY FOOD VENDOR’S APPLICATION <br />1.Date(s): <br />2. <br />Address: <br />Phone: <br />3. <br />4. <br />5. <br />6. <br />9. <br />meats, tamales, cooked beans, rice, <br />venue z • Jb <br />TEMP EVENT APPEHO 1602 <br />06/29/2023 <br />Note: Examples of potentially hazardous food include: <br />vegetables, potato salad, eggs, and dairy products. <br />7. <br />8. <br />Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods: <br /> Aoprbved bottled water. <br />Paga7of11 <br />A-T i ______________Phone; £ <br />f t <br />screening, completely enclosing open food areas. It will also have <br />asphalt, clean tarps and smooth wood are <br />areas from the public. <br />BlSther (specify): pftu j <br />_J______ <br />^75 i <br /> A booth with walls and ceiling constructed of either wood, canvas, plastic, similar material and fine mesh fly <br />r___. —•• •» a a smooth and C|eanabie floor (concrete, <br />acceptable) and constructed to separate food and food preparation <br />fra, le < <br />C-L AUn <br />The following is information about my organization/business: <br />V v-1 <br />I lb ' I; <br />7To ~> Le <br />, i <br />u.' k i < <br />r = ’ f <br />J-Mr! <br />p <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 />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. Name of Event: HOtytiTtyN DatefsV <br />3 On-site hose bib that is connected to a potable water source. <br /> Other (specify): _________________________________ <br />Electricity is provided for my booth's use: Q YesQ No “ '—' <br />I am providing an accurate probe thermometefto measure the hot and cold holding of potentially hazardous <br />foods during all times of booth operation: Yes No <br />1 P|^,vidin9 following hot temperature control for the hot holding of all potentially hazardous foods above <br />135°F: <br /> Camp stove Stpmro & hotel trays <br /> Double steamer .EfSteam table & lids <br /> Electric stove top Other (specify) <br />Name of organization/business: <br />y, <br />(1 v ~ x u- Alternate: ( ) <br />List food to be sold or given to the public:Lvi <br />I am providing food that is NOT prepared at home: Yes No <br />All food is prepared on-site or is from approved commercial facilities: Q Yes No <br />Name of facility: | (* <br />Address of facility: 10, 11________________________________ <br />I am providing a booth with the following: (to protect my unpackaged fo<4d and food-preparation areas from flies <br />dust and the public)