Laserfiche WebLink
TEMPORARY FOOD VENDOR’S APPLICATION <br />required to return a signed and completed copy of this checklist to <br />1.Date(s): 1/20-22/2016 <br />2. <br />Address: <br />Phone:( <br />dried fruit & candy3. <br />4. <br />559-940-0198 <br />CA 93702 <br />5. <br />E] Other (specify): Pre-packaged items only. No food will be prepared on site. <br />6. <br />gal hand washing station. Using disposable utensi1s. <br />7.Electricity is provided for my booth's use: Yes [7] No <br />8. <br />9. <br />Not applicable <br />meats, tamales, cooked beans, rice, <br />Page 7 of 11 TEMP EVENT APP <br /> Sterno & hotel trays <br /> Steam table & lids <br /> Other (specify) <br />Note: Examples of potentially hazardous food include: <br />vegetables, potato salad, eggs, and dairy products. <br />Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods: <br /> Approved bottled water. <br />Note: The only operations not required to provide enclosed booths <br />approved dispensers, or prepackaged foods from approved <br /> Camp stove <br /> Double steamer <br /> Electric stove top <br />EHD 15-02 <br />8/1/14 <br />All food vendors (both for profit and non-profit) are i , ' ‘' <br />the festival coordinator three (3) weeks prior to this event <br />1. Name of Event: Lodi Home and Garden Show <br /> On-site hose bib that is connected to a potable water source. <br />H Other (specify): 5. <br />The following is information about my organization/business: <br />Name of organization/business: Golden State Snacks <br />29225 Revis Road; Coarsegold, CA 93614 <br />are those which sell beverages from <br />sources. <br />I am providing food that is NOT prepared at home: 0 Yes No <br />All food is prepared on-site or is from approved commercial facilities: Yes No <br />Name of facility: Yosemite Concessions Phone: () <br />Address of facility: 3 62 8 E Butler, Fresno, <br />)559-676-6501 <br />I am providing an accurate probe thermometer to measure the hot and cold holding of potentially hazardous <br />foods during all times of booth operation: O Yes 0 No f\io hot or cold holding requirements <br />I am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br />135 F: <br />I am providing a booth with the following: (to protect my unpackaged food and food-preparation areas from flies <br />dust and the public) <br /> A booth 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 />_ Alternate: ( ) <br />List food to be sold or given to the public: Pre-packaged nuts, seeds,