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All food vendors (both for profit and non-profit) <br />G-V ,201^Date(s).1. <br />2. <br />gYY- 2tT7 Wvrr&CA- <br />Address: <br />3. <br />4. <br />5. <br /> Other (specify): <br />6. <br /> On-site hose bib that is connected to a potable water source. <br /> Other (specify): <br />7. <br />8. <br />9. <br />meats, tamales, cooked beans, rice, <br />*u' <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 /> Camp stove <br />Qttouble steamer <br />(□Electric stove top <br />Electricity is provided for my booth's use: 0Yes No <br /> Stemo & 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 />COMPLETE BOTH SIDES AND RETURN WITH EXHIBITOR AGREEMENT <br />I am providing an accurate probe thermometepto measure the hot and cold holding of potentially hazardous <br />foods during all times of booth operation: Q* es Q No <br />* ^35®FVId*n^ th6 ^0W’n® temperature control for the hot holding of all potentially hazardous foods above <br />Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods. <br />tjApproved bottled water. <br />* SCTPA <br />TEMPORARY FOOD VENDOR’S APPLICATION <br />AH 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- <br />The following is information about my organization/business: <br />Name of organization/business:------------------------------------- <br />(2^7 CXM ST <br />Phone. (^ ) rBflj------------------------------ Alternated )_------------ <br />List food to be sold or given to the public: <br />I am providing food that is NQT prepared at home: 0Yes No <br />All food is prepared on-site or is from approved commercial facilities: Yes No <br />Name of facility: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 />[□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, clean tarps and smooth wood are acceptable) and constructed to separate food and food preparation <br />areas from the public.