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Date(s): .I, L <br />2. <br />3. <br />4. <br />5. <br />6. <br />8. <br />hot and cold holding of potentially hazardous <br />9. <br />meats, tamales, cooked beans, rice, <br />the festival coordinator three (3) weeks prior to this event. <br />1. <br />Electricity is provided for my booth's use: Yes No <br />I am providing an accurate probe thermometer to measure the <br />foods during all times of booth operation: 0^es No <br />' por°vldin9 the following hot temperature control for the hot holding of all potentially hazardous foods above <br />CJ Camp stove | | Stemo & hotel trays <br /> Double steamer steam table & lids <br /> Electric stove top other (specify) <br />Note: Examples of potentially hazardous food include* <br />vegetables, potato salad, eggs, and dairy products. <br />COMPLETE BOTH SIDES AND RETURN WITH EXHIBITOR AGREEMENT <br />TEMPORARY FOOD VENDOR’S APPLICATION <br />ihllSi^ndOr5HfbO*th pro™ and non-profit) are required to return a signed and completed copy of this checklist to <br />1. Name of Event/^ if <br />The following is information about my organization/business: <br />Name of organization/business^g-AL^ <br />Address: 1^-2- <br />5^73 <br />( <br />a,______ <br />Phone: ^*73________________ Alternate:^ ) ^6,2^3 <br />List food to be sold or given to the public: <br />I am providing food that is NOT prepared at home: ®Ves Q No <br />All food is prepared on-site or is from approved commercial facilities: ®Yes No <br />Name of facility:___ _______________________Rhone: ( )______ <br />Address of facility:______ <br />' X7and me pS)1 the fOllOWin9: (t° Pr°teCt food and food-preparation areas from flies, <br />^e^nTcoSoteSN^nH0??"9 C°nStSd °f either WO°d' Canvas' plastfo similar serial and fine mesh fly <br />9; con?pletely enclosing open food areas. It will also have a smooth and cleanable floor (concrete <br />aX fromTeSc aCCeptable) and construc,ed to separate food and food preparation <br />EJ Other (specify):___ <br />NOte: Innr^ °.perations not required to provide enclosed booths are those which sell beverages from <br />approved dispensers, or prepackaged foods from approved sources. <br />Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods: <br />S^Approved bottled water. <br /> On-site hose bib that is connected to a potable water source. <br /> Other (specify):