Laserfiche WebLink
i I <br /> f i <br /> Ili � <br /> 1 I <br /> I <br /> TEMP FOOD VENDOR'S APPLICATION <br /> A I food vendors(both for pro it a� no refit)are required to return a signed and completed copy of this checklist to <br /> the festival coordinatorthre$ ) eks Inorto this event. <br /> 1. 1.Name of Event: Date(s), <br /> 2. The following is inform nl ut;y;oLrgan1m,7,aUon/bLmIness: <br /> Name of organizationfb <br /> AdEfreSs: J� �/� S ° <br /> Phone: ( � ) i Alternate:cl,6 } 3F 7 � <br /> 3. List food to be sold or given{ the ublia ' <br /> -- IIi I <br /> 4. 1 am providing food that is M T pril Ipared at home: es❑No <br /> All food is prepared on- ite rl is 1 approved commercial facilities: -'C' [J No <br /> Name of facility; <kG t�S , Phone: 3 `�3 J 36,575 <br /> Address of facility: <br /> 5. I am providing a booth Rh ti a foil,wing: (to protect my unpackaged food and food-preparation;areas from flies, <br /> dust and the public) <br /> i <br /> booth with walls al d Je�fing structed of either wood, canvas, plastic, similar material and fine mash fly <br /> screening, completely +CI Bing c pert food areas. it will also have a smooth and cleanable floor (concrete, <br /> asphalt, clean tarps an srru�oth mbod are acceptable) and constructed to separate food and food preparation <br /> areas from tho public. <br /> C]Other(specify): i <br /> I <br /> Nate: The only operations 4 at r4quired to provide enclosed booths are those which sell beverages from <br /> approved dispe ers r pr �ackaged foods from approved sources. <br /> i <br /> 6. Approved water for dr'.nk ng,l ens!land hand washing will be provided in my booth by the following methods,, <br /> � <br /> ["Approved bottled wat r. i <br /> n-sita hose bib that s�Y, nett to a potable water sourca_ <br /> [ Other(specify): <br /> 7. Electricity is provided for y oth' use: Yes❑No <br /> 8_ 1 am providing an aGcur to f'robe erio measure the hot and Cold holding of potentially hazardous <br /> foods during all times bq•ih o ration: Yes❑ No <br /> i� <br /> 9. 1 am providing the follow rig t to iperature control for the hot holding of all potentially hazardous foods above <br /> ;C� <br /> 54E_ �stove ;l !�=team <br /> &hotel trays <br /> E]Uuble steamer l table&Ilds <br /> ❑Electric stove top i ! Other(specify) <br /> Note-. Examplo& of pote� "ally hmardous food include: meats, tamales, cooked beans, rice, <br /> vegetables,potal o act, gs, and dairy products, <br /> i <br /> V14 15 I Page 7 of 11 'TEMP EVRNT APP <br /> I � <br />