COMPLIANCE INFO - Laserfiche WebLink

Home Browse Search

I Date(s):1. Name of Event:1. 2. Address: ( 7^)Phone: S3 4. 5. 6. Approved bottled water. On-site hose bib that is connected to a potable water source. 7. the hot and cold holding of potentially hazardous8. 9. meats, tamales, cooked beans, rice, Camp stove Double steamer Electric stove top Other (specify):________________________________________ Note: The only operations not required to provide enclosed booths are those which sell beverages from approved dispensers, or prepackaged foods from approved sources. Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods: Other (specify): ___________________ Electricity is provided for my booth's use: I I Yes [2 No I am providing an accurate probe thermometer to measj foods durino all times of booth operation: A Yes PTNo 3 Yes No Phone: (716) TEMPORARY FOOD VENDOR’S APRI^ATION Note: Examples of potentially hazardous food include: vegetables, potato salad, eggs, and dairy products. COMPLETE BOTH SIDES AND RETURN WITH EXHIBITOR AGREEMENT All food vendors (both for profit and non-profit) are required to return a signed and completed copy of this checklist to the festival coordinator three (3) weeks prior to this event. / /Ja //^ </ Date(s): / G foods during all times of booth operation: Yes I am providing the following hot temperature control for the hot holding of all potentially hazardous foods above 135°F: Stemo & hotel trays Steam tabte & lids Bother (specify) The following is information about my organization/business: )___ fl Name of organization/business: / 3 Av S 55*^ 5) \ Alternate: ( List food to be sold or given to the public:. I am providing food that is NOT prepared at home: O Yes S No All food is prepared on-site or is from approved commercial facilities: cu . i_, i-v . Name of facility: Phone: ( Z^Sj Q O I ] j I------ Address of facility:LO tZ—I, i I am providing a booth with the following: (to protect my unpackaged food and food-preparation areas from flies, dust and the public) □Ta booth with walls and ceiling constructed of either wood, canvas, plastic, similar material and fine mesh fly screening, completely enclosing open food areas. It will also have a smooth and cleanable floor (concrete, asphalt, clean tarps and smooth wood are acceptable) and constructed to separate food and food preparation areas from the public.