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TEMPORARY FOOD VENDOR'S APPLICATION <br /> All 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 weeks prior to this eve <br /> 1. 1.Name of Eve Date{s); <br /> 2. The following is information about my orczTion/business: <br /> Name of organization/business: <br /> Address: _ C�a <br /> Phone:., /j -f d Alternate: ( ) <br /> 3. List food to be sold or given to the pub a , <br /> 4. 1 am providing food that is NOT prepared at home>q Yes❑ No <br /> All food is prepared site or is from approved commercial facilities:,�es o <br /> Name of facility- � Phon 2, <br /> Address of facility: <br /> 5. 1 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 accepta and constructed to separate food and food preparation <br /> areas from the public. <br /> Other(speci � <br /> N te: L'/�— <br /> The only operations not requireo to provide enclosed booths are those which sell beverages from <br /> approved dispensers, or prepackaged foods from approved sources. <br /> 6. Ap oved water for drinking, utensil and hand washing will be provided in my hooth by the following methods: <br /> pproved bottled water. <br /> ❑ -site hose bib th�%A connected to otable water source. <br /> 7. Electricity is provided for my booth's use: ❑Yes Na <br /> 8. 1 am providing an accurate probe thermo' r to measure the hot and cold holding of potentially hazardous <br /> foods during all times of booth ope% Yes ❑ No <br /> 9. 1 am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br /> 135°F: <br /> PI-pa mp stove ❑5terno&hotel trays <br /> Double steamer ❑ Steam table&lids <br /> ❑ Electric stove top ❑ Other(specify) <br /> Note: Examples of potentially hazardous food include: meats, tamales, cooked beans, rice, <br /> vegetables, potato salad, eggs,and dairy products. <br /> END 16-02 page?of 11 TEMP EVENT APP <br /> 711 A11 5 <br />