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<br /> 0AII ''JulAgt;IIII &—I lY di yea III ra.;0 1P6u9 424i juI ...t.f-u...
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<br /> TEMPORARY FOOD VENDOR'S APPLICATION
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<br /> the festival coordinator three(3)weeks prior to this event
<br /> 1" 1.Name of Event:led A Sli I I LDate(s)
<br /> 2• The folfowing is information about my organization/business:
<br /> ,Jar„a a.nrga aLorrlbusiness: 'y r 4 , ?
<br /> Address:
<br /> Phone:
<br /> 3- List food to be sold otgiven to the public- J j
<br /> 4- 1 am providing food thaI.is NOT prepared at home Yes❑No
<br /> All food is prepared o �,rj
<br /> or is from approved commerc4il farilitieal-. Yes❑No
<br /> Name of facility - �' LU-U• Phone:L20)}9 ci Address of facility (D C h 1
<br /> 5. 1 am providing a booth with the following:(to protect my unpac-kaged food and food-preparahon srea3s from flies
<br /> dust and the public)
<br /> ❑A booth with walls and celing constructed of aitfier wood,canvas,plastic,similar mateaaf anA firi-6 rnesfi fly s
<br /> screaming; cornp{etely enck�ning pperr food-areas 16 w4 also Dave a smaoih'acid-cleanahle,fiDor 1rorr }e
<br /> asphalt,dean tarps and smooth wood are acceptable)and constructed to separate food aiad�ti pre �tiort
<br /> areas from the public. -
<br /> c3ther{specify): )L k 1 p �[�f}�1']v
<br /> Note: The only operations not required to p.0Jlde enclosed booths am_ those which sell beuet�ges fir�ttt
<br /> apprnved drspensers,os p=epntkaged fooris frarn ar prov6d sources. #.`
<br /> 6- Approved water for drinking, utensil and hand washing will be provided in my 60?th by the fgllowQ�q:mpttrods ?r
<br /> []Approved bottled water.
<br /> ❑on-site hose bib that is connected to a poLnble water source.
<br /> other(specify): �tl"h't
<br /> 7. Electricity is provided for my booth's use:❑Yes Nrd cold ho`din of p8. 1 am providing an accurate probe thermartteter to meas3
<br /> foods during all times,of booth operation:❑Yes No iV�
<br /> 9- 1 am providing the following hot tsrnpemture control for the hot holding of 2M pokentiatly hazardous foods atieve
<br /> 135°F
<br /> �camp�� ❑Skerno&hotel.trays
<br /> porthle steamer ❑Steam table&lids
<br /> E `B Other(spec/ify)
<br /> Electric stove top
<br /> fJ ► a�] � f � meats, tamales, coAed beans, rice,
<br /> EX�i7t IL's Wi entlaIIy 3z d°us D InC1u
<br /> Note: P and dairy products.
<br /> # W r otato salad,eg9sr
<br /> rt
<br /> 4, vegetables p
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<br /> �Y\, ZFXAt'EV�l4T AFY
<br /> 4 1868 Hazelton Avenue j Sfockton,Galifomia 9520 � �20g 4B8 3420rF{
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