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TEMPORARY FOOD VENDOR’S APPLICATION Date(s): I.Name of Event.1. 2. 2 Address: Phone: List food to be sold or given to the public:3.r>-i <2 4. 5. .0Other (specify):<■ Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods:6. Approved bottled water. On-site hose bib that is connected to a potable water source. Other (specify): 7, 8. 9. meats, tamales, cooked beans, rice, TEMP EVENT 4.POPage 7 of 11EHD 16-02 7/14,>15 Name of facility: Address of facility:. 0 A 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. Sterno & hotel trays Steam table & lids Other (specify) Camp stove Q Double steamer B^EIectric stove top -• Q q k C_A _______ Alternate: (J21/}) cl 'O I - M 1_________ Note: Examples of potentially hazardous food include: vegetables, potato salad, eggs, and dairy products. I am providing the following hot temperature control for the hot holding of all potentially hazardous foods above 135°F: Electricity is provided for my booth’s use: &Yes Ep-Tfr I am providing an accurate probe thermometepto measure the hot and cold holding of potentially hazardous foods during al) times of booth operation: Sr'es^^ffo Note: The only operations not required to provide enclosed booths are those which sell beverages from approved dispensers, or prepackaged foods from approved sources. The following is information about my organization/business' Name of organization/business: MUG (G) £ I 1 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. Vo 2__U^K_ I am providing food that is NOT prepared at home: Sere's SfNo All food is prepared on-site or is from approved commercial facilities: ® Yes No VTu/yg^Phone. (-Ztxq) L/1. G - i /a.., c i c i ‘Ss <~x , A1 ‘A <^-0 L-_________ I am providing a booth with the following, (to protect my unpackaged food and food-preparation areas from flies, dust and the public)