Laserfiche WebLink
TEMPORARY FOOD VENDOR'S APPLICATION <br /> All k7od vendors(both'or Pad and mi-prort)are tD retum a svied and <br /> tho testmal coordinator three(3)weeks prior tD this event °OrroEsed of tlrs dledclist 1D <br /> .1. 1.Name of Event ;,?eily i'rsCr1 /'�y lZt IJS l.�'/�)"�G ct'�7 G.IOII� oatAe(s�' <br /> 2_ The following is information about my organization/business, e E 7� D 0 <br /> Name of organization/business: <br /> r <br /> r <br /> Address: 60C> <br /> Phone: ( ti 00 )o"t - c7 9 C'n Alternate: b <br /> 3 list food to be sold or given to the public_ //14 i� 17o"V t-73 <br /> 4. 1 am providing food that is NOT prepared at home: [SJ°Yes E]tNo <br /> All fOW is prepared on-site or is from approved commercial faciliQies:[]Yes❑No <br /> Flame of facility: Phone: ( 1 <br /> Address of facilit3r <br /> 5_ 1 am providing a booth with the following:(to protect my unpac kaged food and food-preparation areas from flies, <br /> dust and the public) <br /> gA booth vAth 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 clearable 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(sue): <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 folkmiing methods: <br /> Approved bottled vaster. <br /> KN <br /> 0 On--site hose lib that is connected to a potable water source. <br /> ®Other(specify). <br /> 7. Electricity is provided for my booth's use: 0 Yes (No 6 ,,Ie i <br /> 8. l am providing an accurate probe thermometer to measure the hot and cold holding of potentialy hazards <br /> fads during all times of booth operation: WYes® No <br /> 9. l am providing the following hot temperature control for the hot holding of all paWaity hazardous Roads at <br /> 13b"l=: <br /> camp stove F1 Stemo&hotel trays <br /> p Double steamer ® Steam table&lids lJ s <br /> Do <br /> Electric stave top ❑ Otner(specify) <br /> Note: Examples of potentially hazardous food include: meats, tamales, cooked beans, <br /> vegcdables, potato salad,eggs.and dairy products. <br />