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TEMPORARY FOOD VENDOR'S APPLICATION <br /> All food vendors (both for prom and non-oroft) 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. ?.Name of Event: <br /> 2- The following is information about my organ izaton/business: <br /> Name of crgar,iza ion/business: { , 1 ff) _'L <br /> Address: / ti±� n � ' � <br /> Phone: <br /> Alternate: ( ) <br /> 3. List food to be sold or given to the public: YS <br /> 4, 1 am providing food that is IYOT prepared at home:iff Yes ❑No <br /> All food is prepared on-site or is rrc;r. approved commercial facilities:Z�Yas ❑ No <br /> Name of facTty: �— ;ern c��_5 y Y1 �s-, Phone: ( ,i , <br /> Address of facility: A _Z - ) '::'rn C)r-,, Ciar 9S3Z:3 G <br /> 5. 1 am providinc a booth with the following: (to protect my unpackaged food and food-preparation areas from flies, <br /> dust and the public) <br /> ❑ A boot-i with walls and ceiling constructed of either wood, canvas, plastic, similar material and fine mesh. fly <br /> screening, ccmpletely enciosirg open food areas. It will also have a smooth and cleanable floor (concrete, <br /> asphalt, clean tarps and smooth ,Lvood are acceptable) and constructed to separate food and food preparation <br /> areas frorn the public- <br /> Other(specify): <br /> Note: The only operations not required to provide enclosed 'booths are those which sell beverages from <br /> approved d:spensers, or prepackaged foods from apprcved sources. <br /> o. Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods: <br /> Approved botied water, <br /> �1 On-site hose bib thatlis ccnnected to a potable water scurce. <br /> t <br /> ❑ Other(specify): <br /> 7. Electricity is provided for my booth's use: ZYes ❑ No <br /> 8- ; am providing an accurate probe thermometer to measure the hot and cold folding of potentially hazardous <br /> foods during all times of booth operation:Zj Yes ❑ NVc <br /> 9. 1 am providing the following ho'temperature control for the hot holding of all potentially hazardous foods above <br /> 135°F: <br /> Camp stove ❑ Stemo& hotel trays <br /> ❑ Double steamer ,�Steam table &Ilds <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 /> FHD 16-02 Page 7 of 11 <br /> 7114115 TEMP EVENT APP <br />