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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(3)weeks prior to this event. <br /> 1. 1.Name of Event: ;�,,J �,,r vv� �Gr p,) Date(s): 9 7-6/ <br /> 2. The following is information about my organization/business: <br /> __� I <br /> Name of organization/business: � "t- C_,�r�ri►r�.•dc�rt a �C,,,,i <br /> Address: �`� u `7q <br /> Phone: ( ' ) `°— 544 (J Alternate:( ) <br /> 3. List food to be sold or given to the public: �e <br /> 4. 1 am providing food that is NOT prepared at home:ID Yes❑ No <br /> All food is prepared on-site or is from approved commercial facPlities:j[ /Yes❑No <br /> Name of facility: Phone: <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 /> __d�ust and the public) <br /> ' <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 acceptable) and constructed to separate food and-food preparation <br /> - areas from the public. <br /> ❑ Other(specify): <br /> Note: The only operations not required to provide enclosed booths are those which sell beverages from <br /> approved dispensers,or prepackaged foods from approved sources. <br /> 6. Approved water for drinking,utensil and hand washing will be provided in my booth by the following methods: <br /> 21 Approved bottled water. <br /> ET/On-site hose bib that is connected to a potable water source. <br /> ❑Other(specify): <br /> 7. Electricity is provided for my booth's use:❑Yes Jo <br /> 8. I am providing an accurate probe thermometer to measure the hot and cold holding of potentially hazardous <br /> foods during all times of booth operation:❑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 /> ❑Camp stove N 7 ❑Sterno&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 /> EHD 16-02 Page 7 o111 TEMP EVENT APP <br /> 7/28110 <br />