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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: -/-n F} �� C�'_A"'�ti 5,5►^p/�c�S Date(s):TuN ff, a-���,� <br /> W ti-t:eP2M0,/nil 37i2e<!7C T-)n <br /> 2. The following is information about my organization/business: <br /> a <br /> Name of organization/business: 0. ' 449 <br /> / <br /> "7 �A ) <br /> Address: � <br /> Phone: (7�' ./ ) 7 * -�'� 'Z� <br /> Alternate:(44) ) C6k, <br /> 3. List food to be sold or given to the public:ke-H I�e_C o,r2 Vi S AV21 g i!0-S' 8 fF,,�, yf�004S, L e yam, <br /> 4. 1 am providing food that is NOT prepared at home: �V'5/Yes❑ No <br /> All food is prepared on-site or is from approved commercial facilities: WYes❑ No <br /> Name of facility: Phone: f 1 <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 /> AI booth with walls and ceiling constructed of either wood, canvas, plastic, similar material and fine mesh fly <br /> s reening, 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 /> ❑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 No <br /> 8. 1 am providing an accurate probe thermometw to measure the hot and cold holding of potentially hazardous <br /> foods during all times of booth operation:VXes❑ No <br /> 9. 1 am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br /> AJ1__135°F: <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 I SIDES AND RETURN WITH EXHIBITOR AGREEMENT <br />