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� KJ | �� � i &� <br /> � 0 ^ | D � HU � C� �����~����������� U����N�� ������«������� <br /> � - ' - ' Department <br /> - - <br /> �_ ( U �� IY--- <br /> G/enn`��� <br /> ���������� ����� �������,� APPLICATION <br /> _ ~_,,,, `~~ ,, ,, , , , ~,~~~, _ ~_,�~~~~,~ ~� <br /> All food vendors (both for profit and are required to return asigned and completed copy oy this checklist to <br /> the festival coordinator three CBtmmekonhnr0nth�seymnL <br /> l. 1 of Event. Va/ <br /> 2. The following is information about mnyorgan n/busi - <br /> Name of organ ization/business: _'14cld <br /> ci `7) <br /> Address: - 4 1 1, k <br /> Phone: Alternate: <br /> 3. List food to be sold or given to the public: A) 1), <br /> 4. | am providing food that is NOT prepared a1 home: M\��sFNn <br /> All food is prepared on-site or is from approved cnrnnneroia|facilities:� Yes F� No <br /> Name of facility: Phone: <br /> Address offacility: <br /> 5. / um providing n booth with the following: (to protect nnyunpaokao9U food mndfnod'prnoara1ion areas from flies,duytandtbepub|ic) ' <br /> El Abooth with walls and ceiling constructed of either wood, uunvan, p|astin, similar material and One mesh fly <br /> onreoning, completely enclosing open food areas. It will also have aonnootb and cleanable fluor (concrete, <br /> aapha|t, clean tarps and smooth wood are acceptable) and constructed to separate food and food preparation <br /> areas from the public. <br /> 90ther(apen|fy): <br /> Note: The only operations not\;m�uired to provide enclosed booths are those which sell beverages from <br /> approved disponoers, or prepackaged foods from approved sources. <br /> O. Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods: <br /> R�A <br /> �� <br /> pprnvedbntUedm/ater. � <br /> FlOn-site hose bib that is connected 0oa potable water source. | <br /> Fl Other(spnoih): <br /> . Electricity~ provided for^'' booth's use: 0 .e= ' <br /> 8 | am providing an accurate probe thermometer to measure the hot and cold holding of ' � 1L|yhazard`uo <br /> | ! <br /> foods dur�goUdnxeoofboo� —�-`-` � <br /> S. 1 am p0VN|Dg the following hot temperature control for the hot holding of all potentially h�G�oUo ��s above ' <br /> 135°F� ' <br /> El camp stove ElStemo& hotel trays <br /> L� Double steamer AStoamkabky 8|idu <br /> �lElectric stove top Fl Other(speuify) <br /> Note: Examples of potentially hazardous food include: mnwats, tammmlmm, cooked beans r�om <br /> vegetables, potato salad, eggs, and dairy products. , ' <br />