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TEMPORARY FOOD VENDOR’S APPLICATION <br />•J naniu v/i uvctil. <br />2. <br />Name of organization/business: <br />US SXAddress: <br />L| QQ. - UP 3$2>qs -(XcS){Uo<v)Phone: <br />List food to be sold or given to the public: 3. <br />4. <br />5. <br />Co <br />ADoroved water for drinking, utensil and hand washing will be provided in my booth by the following methods:6. <br /> Approved bottled water. <br />I | On-site nose bio that is connected to a potabie water source. <br /> Other (specify): <br />meats, tamales, cooked beans, rice. <br />r . <br /> Camp stove <br />| | Double steamer <br /> Electric stove top <br /> Stemo & hotel trays <br /> Steam table A lids <br /> Other (specify) <br />\ ik r 1 <br />Pbther (specify): v <br />Note: The only nperaHnns not required to provide enclosed booths are those which sell beverages from <br />approved dispensers, or prepackaged foods from approved sources. <br />( ~ <br />Alternate: <br />Electricity is provided for my booth’s use: YesE^No <br />Note: Examples of potentially hazardous food Include: <br />vegetables, potato salad, eggs, and dairy products. <br />I am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br />135OF: <br /> A booth with walls and ceiling constructed of either wood, canvas, plastic, similar material and fine mesh fly <br />Screening, compieieiy enclosing open iouu dieus. Il will cn&u nave Ct aiiuuui anu ucaiiaura hvwi <br />asphalt, clean tarps and smooth wood are acceptable) and constructed to separate food and food preparation <br />areas from the public. <br />i \ L R <br />|\;tx -! am providing an accurate nrnhp thermometer to measure the hot and cold holding of potentially hazardous <br />foods during all times of booth operation: Yes No <br />I am providing food that is NOT prepared at home: Q Yes No <br />All food is prepared on-site or is from approved commercial facilities: 0 Yes No <br />Name of facility: c Phone: (X<H)_ <br />Address of facility:lOkx. s . r, A_____________________________— <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 />All fuuu venums (both fur proiri and non-profit) are required io return a signed and completed copy of this checklist to <br />the festival coordinator three (3) weeks prior to this event a \ <br />Daie(s)\ <br />The following is information about my organization/business: