COMPLIANCE INFO - Laserfiche WebLink

Home Browse Search

TEMPORARY FOOD VENDOR'S APPUCATiON All food vendors (both for proft and non-profiit)are required to return a signed and completed copy of this checklist to the fest#vaf coordinator three.(3)weeks prior to this event" 1. Name of Event: Soaring Over Ripon Vloi Air Balloon Pesiaval and Kiie'Sho�v 9i311 b-9I4/16 ate. 2 The following is information about my organ izaticn,busl ness: Name of organization/business: Gotta Love Kettle Corn Address: 2324 Demartind Ln ?ho;,e: ( 51U y 43.2-6165 .4ltemafe:(510 ) 334-�829 3. List food to be sold or given to the public: kettle corn, lemon shakers, sweet& grill corn on the cob, water/soda 4. 1 am providing food that is NOT prepared at hone:[R Yes❑No All food is prepared on-site or is from approved commercial facilities: ❑Yes ❑ iNo Name offacaity: Phone: Address of fapffy. 5. 1 arr providing a booth with the following:(to protect my unpackaged food and food-preparation areas from flies, dust and the public) ® A booth with walls and ceiling constructed of elther wood, canvas, plastic, similar material and Tine mesh Tly screening, completely enclosing open food areas_ It grill also have a smooth and cleanable floor (concrete, asphalt, clean tarps and smooth wood are acceptable) and constructed to separate food and food preparation areas from the puhtic. Ej Other(specify): Note: The only operations not required :c provide enclosed booths are those which sell beverages from approved dispensers, or prepackaged foods from approved sources. 6. Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods: ®Approved bottled water. 11— On-site hose bib That is connected to a potable water source. ❑ Other(specify): Z 'Electricity is provided for my booth's use: ❑Yes(2 Nc 8_ t am omvid ng an zcGj:ate. prole te,-roorneter'to measure the 'not acid cold holdtzg of pztent,lIy hazardous foods during all times of booth operation: M Yes❑ No 9. 1 am providing the following hot temperature control for the hot holding of all potentially hazardous roods above 135�P: Not Applicable ❑ Camp stove ❑ Stereo&hotel trays ❑ Double steamer ❑ Steam tabie&lics 'Eleciric stovetop ❑Other(specify) Note: Examples of potentially hazardous food include. meats, tamales, cooked means, rice, vegetables, potato salad, eggs, and dairy products. EMD 16-D2 Page 7 of 11 7114115 TEMP EVENT APP