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TEMPORARY FOOD VENDORS APPLICATION <br />Date(s): y/m & 2~£>j£1. <br />2. <br />Address: <br />Alternate: (^2-^ )Phone: <br />3.Z7/7 <br />4. <br />5. <br />Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods:6. <br />□ Other (specify): <br />fes NoElectricity is provided for my booth's use:7. <br />8. <br />9. <br />meats, famaless cooked beans, rice. <br />TEMP EVENT APPPage 7 of 11EHO 16-02 <br />8/1/14 <br /> Approved bottled water. <br />E'dn-site hose bib that is connected to a potable water source. <br />I am providing an accurate probe thermometei; <br />foods during all times of booth operation: C <br /> Camp stove <br /> Double steamer <br /> Electric stove top <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 />E^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 /> Other (specify): _ _______ <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 & hotel trays <br /> Steam table & lids <br /> Other (specify) <br />List food to be sold or given to the public: <br />Note; Examples of potentialiy 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 />135°F: <br />I am providing food that is NOT prepared at home; QJ'Yes No <br />All food is prepared on-site or is from approved commercial facilities: E^fes No <br />Name of facility.Phone: (1 <br />Address of facility: <br />netei>to measure the hot and cold holding of potentially hazardous <br />[0fyes O No <br />All food vendors (both for profit and non-profit) are required to return a signed and completed copy of this checklist to <br />the festival coordinator three (3) weeks prior to this event. , d <br />1. Name of Event: <br />The following is information about my oraanizatirmbusiness: <br />Name of organization/business: <br />b ^3/32 -3/32-_______ <br />( 1~33ty Alternate: '2-' 233