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TEMPORARY FOOD VENDOR’S APPLICATION <br />1. <br />2. <br />Address: <br />Phone: <br />List food to be sold or given to the public:3.AST) <br />4. <br />.Art ZhMTYis <br />5. <br />Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods:6. <br /> Approved bottled water. <br />On-site hose bib that is connected to a potable water source. <br /> Other (specify): <br /> NoElectricity is provided for my booth's use:7. <br />8. <br />9. <br />meats, tamales, cooked beans, rice, <br />TEMP EVENT APRPage 7 of 11EHD 16-02 <br />7/14/15 <br /> Camp stove <br /> Double steamer <br /> Electric stove top <br />Note: Examples of potentially hazardous food include: <br />vegetables, potato salad, eggs, and dairy products. <br />I am providing an accurate probe thermomeb <br />foods during all times of booth operation: EZ <br />I am providing a booth with the following: (to protect my unpackaged food and food-preparation areas from flies, <br />dust and the public) <br />I am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br />135°F: <br />Hsterno & hotel trays <br /> Steam table & lids <br /> Other (specify) <br />net^to measure the hot and cold holding of potentially hazardous <br />0res No <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 publb^ u-||( rVOVY) -Pyvyy) Orw Obt'h.lcC^ <br />H Other (specify): <br />krlzkcn i$ -jv rtw/n s&MLr&Ae frwi rb th-t <br />Note: The only operations not required to provide enclosed booths are ahose which sell beverages from <br />approved dispensers, or prepackaged foods from approved sources. <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 Name of Event: 5 I If <br />The following is information about my organization/business: <br />Name of organization/business: <br />fhcific S^T>cJchyi Cf\ ^52J)'7 <br />(W Alternate: ( ) <br />I am providing food that is NOT prepared at home: [^Yes No <br />All food is prepared on-site or is from approved commercial facilities: Hr es No <br />Name of facility: 641/1/ Phone (^<0^) <br />Address of facility:, %6>/ fabric Art Cft' ^^7