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TEMPORARY FOOD VENDOR S APPLICATION <br />1. <br />2. <br />Address: <br />Phone: <br />3.Ust food to be sold or given to the public: <br />4. <br />5 <br /> Other (specify): <br />6. <br /> Other (specify): <br />Electricity is provided for my booth's use: Yes No7. <br />I am providing an accurate probe thermometer to measure the hot and cod holding at potentially hazardous8. <br />9 <br />FiJCM 7 0»< 1 TEMP EVENT ARPCHD ’5<I2 <br />Approved water for drinking, utensil and hand washing will bo provided in my booth by the following methods: <br />Approved bottled water. <br />® On-sito hose bib that is connected to a potable water source. <br /> Camp stove <br /> Double steamer <br /> Electric stove fop <br />booth with walls and ceiling constructed of either wood, canvas, plastic, sznllar material and fine mesh fly <br />screening, comptetoly 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 />I am providing a booth w<h the following: (to protect my unpackaged food and food-preparation areas from flies, <br />dust and the public) <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 /> Stemo A hotel trays <br /> Steam table A lids <br />pother (specify) <br />meats, tamales, cooked beans, rice, <br />The following is informabon about my organoation/busmess. <br />Name of organization/businessi J Q rp <br />^52S' $■ ol-jHl <br />(£0^555-1'1'7'?Aiternate: 6>6>3-g9'3Cj <br />Note: Examples of potentially hazardous food include: <br />vegetables, potato salad, eggs, and dairy products. <br />foods during all times of booth operation:^Q^Ycs No <br />I am providfog (ho following hot temperature control for the hot holding of all potentially hazardous foods above <br />13ST: <br />I am providing food that is NOT prepared at home^iyes □ No <br />All food Is prepared on-site or Is from approved commercial faoWlos Yes No <br />Name of facility: Phone: () <br />Address of facility: <br />All food vendors (both for profit and non-profit) are required to return a signed and completed copy of this checMiat to <br />the festival coordinator three (3) weeks prior to this event <br />1. Name of Event: I tP | Oc^r (SFP-/-/Date(s):