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2. ^55^^ 3. 4. 5. 6. 7. 8. 9. meats, tamales, cooked beans, rice, TEMPoOIrY FOOD VENDOR’S APPU^TION 1. t.Name of Event <7hirrhinas in ^^-e. P<xr k The foflowing is information about my organization/business: Name of organization/business: {V\a>\la 1 S | 6<Co 5 fe Address: P iMv-»ns: IfXAO MlWorg, Phone: OV) > - ?6O~) AHemate:fc2g)> 3^-J - l_Z2J. List food to be sold or given to the public: IkzsyiZtm^lesprp, I am providing food that is NOT prepared at home: ^Yes No i All food is prepared on-site or is from approved commercial facilities'^ Yes Q No Name of facility: _________________LPtine: ( ) Address of facility: ___ _ 13d?.ftTnd tS3 Wi,h the fol,owin9: (t0 Protect mV unpackaged food and food-preparation areas from flies, Qusi and tne public) .S’"9 const?^ of either wood’ ^vas, plastic, similar material and fine mesh fly Jon?ptetely e00108’^ open food areas. It will also have a smooth and cleanable floor (concrete S fr^TeXbhc30 S acceptable) and instructed to separate food and food preparaton O Other (specify): _____' Note: The only operations not required to provide enclosed booths are those which sell hewers™** approved dispensers, or prepackaged foods from approved sourced beverages from Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods: •^-Approved bottled water. On-site hose bib that is connected to a potable water source. Other (specify):______________ Electricity is provided for my booth’s use:^yes No ' ** hOt and hazanfous ' aithe f0"°Win9 hOt temperature for hot holding of all potentially hazardous foods above Camp stove '^xStemo & hotel trays Double steamer O Steam table & lids Electric stove top Other (specify) Note: Examples of potentially hazardous food include: vegetables, potato salad, eggs, and dairy products. COMPLETE BOTH SIDES AND RETURN WITH EXHIBITOR AGREEMENT