Laserfiche WebLink
TEMPORARY FOOD VENDOR’S APPLICATION <br />j <br />Date(s): 1. Name of Event: 1. <br />2. <br />Name of organization/business: <br />Address: <br />3. <br />4. <br />5. <br />those which sell beverages from <br />6. <br />7. <br />8. <br />i <br />9. <br />TEMP EVENT APPPage 7 of 11EHD 16-02 <br />7/14/15 <br />j <br />5 <br />jAll 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 />0 Camp stove <br />0 Double steamer <br /> Electric stove top <br />Note: Examples of potentially hazardous food Include: <br />vegetables, potato salad, eggs, and dairy products. <br />foods during all times of booth operation: Yes No <br />I am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br />135T: <br />O Sterno & hotel trays <br /> Steam table & lids <br />Other (specify) <br />meats, tamales, cooked beans, rice. <br />Allemale: / Z > S <br />The following is information about my organization/business: <br /> <br />Phone: (720 —---- - <br /> <br />List food to be sold or given to the public: "7'/^', <br />I am providing food that is NOT prepared at home:^jYes 0 No <br />All food is prepared on-site or is from approved commercial facilities: [S’Yes 0 No <br /> Name of facility: 2- 7 Phone: ----- <br /> Address of facility:/%#✓#</ £ -----------------— —---------------------- ----------- <br />I am providing a booth with the following: (to protect my unpackaged food and food-preparation areas from flies, <br />dust and the public) <br />0 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 />asphalt, ciean tarps and smooth wood are acceptable) and constructed to separate food and food preparation <br />areas from the public. <br /> 0 Other (specify):' <br />Note: The only operations not required to provide enclosed booths are <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 /> Approved bottled water. <br />0 On-site hose bib that is connected to a potable water source. <br />0 Other (specify): —---------------—--------------------------— <br />Electricity is provided for my booth's use: |$ Yes 0 No <br />I am providing an accurate probe thermometer to measure the hot and cold holding of potentially hazardous