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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 M AN, <br /> EC C12OSS ASS A)AT i=,2 0� LO Date(s): 060 q !2 LLc),s <br /> 2. The following is information about my organization/business: <br /> Name of organization/business.- <br /> Address: <br /> Phone: (rg��^�) �c1 ��-� ° Alternate: ( ) <br /> 3. List food to be sold or given to the public: i,-A l X i cU yi :60u C� <br /> 4. I am providing food that is NOT prepared at home: R"Yes❑ No <br /> All food is prepared on-site or is from approved commercial facilities: 52'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 /> dust and the public) <br /> dAbooth 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 /> ❑Approved bottled water. <br /> 211On-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 El"No <br /> B. 1 am providing an accurate probe thermometer to measure the hot and cold holding of potentially hazardous <br /> foods during all times of booth operation: B"Yes❑ No <br /> 9. 1 am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br /> 1350E- <br /> camp stove ❑Stemo&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 /> COMPLETE BOTH SIDES AND RETURN WITH EXHIBITOR ,AGREEMENT <br />