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i : I I • ■ ■SAN JUAODIN ’ | i 1 I I < • ■ t I I '■ 1 : '. I <br />TEMPORARY I'OOI) VENDOR'S APPLICA I ION <br />l)<iU;(s) <br />1 N.imn of I vcnrl <br />Address <br />Phone <br />3 <br />A <br />6 ' <br />6 <br />| | Appiovcd bolllcd water. <br />H/A <br />vegetables, potato salad, eggs, and dairy products. <br />« <br />•.VK.C/ <br />-Cm <br />approved crinuncrcial facililies^Kl Yes i i No <br />. v < Phono. fHU) T'AAv <br />i loine of organization/bnsiness <br />131 1 <br />(/?ttV) 3xc./5 <br />i n4x. <br />P5 <br />•I ls/z-5 <br />. ■ . ’ I !.l/< ■ '(,11 ''.Vi'lllb' <br />I «•,) 'I, <br />;l. •>»••• ?l <br />meals, tamales, cooked beans, rice. <br />.( ii I ■.il.li iiv.: <‘ • I "|1' :‘l ; ■■! '• I <br />I >.i.|e • <br />| On-site hose bib that is connected to a potable water source <br />W Other (specify).. . <br />tflcclricily is provided for my booth's use | I Yes I I No <br />I am providing an accurate probe thermometer to measure Hu: hot and cold holding of potentially haz-u.lo . <br />foods during all times of booth operation. I | Yes 54 No <br />I am providing the following hot lemporahire control lot the hot holding of all polenlially h<i/ardous foods aoovi <br />135'1 <br />I | Camp stove ! 1 Slerno X hotel trays <br />I | Double steamer I Steam table & lids <br />! | I leclnc sieve top I ! Olher (specify) <br />Note: l-xamplns of potentially hazardous food include: <br />All kwl «»><!<« (both lor prolrt .Hid non inol.t) orc req......(I Io ml,on n signori and rainplrtlerl copy ..I this rthocKHst io <br />me festival coordinator tlaec (3) weeks prior to Uns event <br />I he following is information aboul my otganization/busincss. <br />-TVv <br />554 ■ <br />Ctv<rCs' Mix <br />S tL C f i w\ C i s v f <br />Alternate (iT^c) ' 5 •" <br />l ist food to be sold oi given to Ihe public < p\\ e k,. j <br />I am providing food that is NOT prepared at homc.J><f Yes ! I Mo <br />All food is prepared on site or is from ; <br />Name of facility: ' <br />UmMMOwling'a booth with1 the followmg (<o protect my unpackaged loud and food preparation areas bom Des. <br />dust and the public) <br />I I A booth will, walls and ceiling constructed of either wood, canvas, plastic, similai malenai and fine mesh, fly <br />screening completely enclosing open food areas It will also have a smooth and ceanable floor ((.onue c <br />asphalt, clean imps ;md smooth wood arc acceptable) and constructed to separate food and food piepmahon <br />areas from the public. <br />M Other (specify) . ' ^Px-C. ' 7 ‘ J <br />Noto: I he only oper.it,ons not required Io provide enclosed Irnolhs .ire those wmdi sell bovernqes Iron, <br />.•ipprovtxl disponsors nr propackarjiul foods from approved soiiK.cs <br />Approved waler for di inking ulens.l and hand washing will be provided in my booth by lhe following methods <br />lil."l M'