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TEMPORARY FOOD VENDOWS APPLICATfON <br /> All food vendors(both for profit and norr-profrt)are required to return a signed and completed copy of this cyst to <br /> the festival coorclinatDr three(3)weeks prior to this event 2 <br /> T. 9.Name of E%rerrft r >rr Di•!G! l�tt D ti� Date(sr 1-3 <br /> 2" The folkwing is Wnrmation about my organization/business: <br /> Narne of oroanizatiorrfbusiness: / t1> C5 A C`41✓�r?a <br /> .T. <br /> Address: 7�3 Y� �Cc�.�y- <br /> Rione: (�G�) S`G S ? —�` Ait'ermate: <br /> 3_ List food to be sd d or Given to the pLdic: -s 01160,54 {A�S <br /> 4. 1 am providing food that is MOT prepared at hoar¢N Yes 0 No <br /> Ali food is prepared on-site or is from appmPied facffifies:in Yes 0 No <br /> Name of€acidity: r C r r PNNW-(top) SO 3— G 5 _ <br /> Address of 913 d <br /> 5. 1 am providing a tooth with the fdlowitg:(to protect my unpaccacged food andtod-preparabon ass frown ties, <br /> dust and the pubic) <br /> A booth with walls and ceiling constructed of either wood,r areas, pWsUc,sirrridar matoriai acid fine mesh fly <br /> smerting. completely enclosing open food areas. It will also twee a srmoth and deanaUe floor (corcrete, <br /> asphalt,clean tarps and smooth wood are acceptable)and constructed to separate food and food preparation <br /> areas from the public. <br /> []Other(specify): <br /> Tote: The only operations not required to provide enclosed booths are those which sel: beverages from <br /> approved dispensers,or prepackaged foods from approved sources. <br /> 6. Approved vvat;:r for drkWng,utensil and hand washing wig be provided in my boottr by the following rrrethod& <br /> OR Approved botf)ecd water" <br /> ❑Once hose bib that is cor-aected to a pv?ade der source. <br /> [I ostler(S = <br /> 7. l=ledricity is provided for rsry bodtr's use:M Yes C1 No <br /> 3. 1 am providing an accurate probe therrnorneter to measure the trot and oold holding of potentia y ha?.a,-dous <br /> foods during all tunes of tooth operation:[XYes❑No <br /> 9- 1 am praovidirrg the foilowang hot ternperatwae control for the tot hoidang Ball poterdially haaardws�t-'d-s abmfe <br /> I WF: <br /> i0 Cam store ®Stem&total trays <br /> Double sleanrer Steam table&lids <br /> ❑ Electric stove top ❑Dotter(may) <br /> Note: Examples of pobentlatiy hazardous food Include: nwats, Urnaies, cooked beans, race, <br /> Vegetables, potato salad,eggs,and dafry producfis_ <br /> EHU 16-02 Parr 7 of 11 TEW EVENT APP <br /> �r_a10 <br />