Laserfiche WebLink
Mar. 4. 2016 1:OOPM No. 2854 P. 32GHI RARDELL I <br />TEMPORARY FOOD VENDOR’S APPLICATION <br />1. <br />2. <br />3. <br />4. <br />5. <br />/ 0 XZ O <br />6. <br />7. Yes No <br />8. <br />9. <br />meats, tamales, cooked beans, rice, <br />Page 7 of 11 TEMP EVENT APP <br />4. 2016 1 2:50PM No. 0539 <br />EHD 16-02 <br />11/4/14 <br />7 T6 LT" <br />Alternate: 7 — <br />Ch <br />feorvc. — <br />are those which sell beverages from <br />Dals(s): 3 / lC) <br />E3 Camp stove Q Sterno & hotel trays <br /> Double steamer steam table & lids <br />ED Electric stove top 0 Other (specify) <br />Note: Examples of potentially hazardous food include: <br />vegetables, potato salad, eggs, and dairy products. <br />Received Time Mar. <br />All food vendors (both for profit and non-profit) are required to return a signed and completed copy of this checklist Io <br />the festival coordinator three (3) weeks prior to this event. <br />1. Name of Event: I An/)t/nL (t'A ) r Q d (UX^ _ <br />The foliowing is Information about my organization/business: <br />Name of organization/business: W) Q. Lj XtS \ O CiCL.P <br />Address: & I Q C <br />Phone: (,<7<3) S/~ *7 ^-97 j <br />List food to be sold or given to the public: Cr T~cVn n <br />I am providing food that is NOT prepared at homacS'Ves No <br />All food Is prepared on-site or is from approved commercial facilitiescQTes H No <br />Name of facility: 7b \i V< QcDusUs (^/Q .^ ) ~D ~ 7^ V 7 <br />Address of facility:^' Z. 1^- Sfr p > f Y/g <br />( am providing a w'dT the following: (to protect my unpackaged food and food-preparation areas from flies, <br /> A booth with walls and celling 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 cleanabls floor (concrete <br />asphalt, clean tarps and smooth wood are acceptable) and constructed to separate food and food preparation <br />areas from the public. K <br />pother (specify): / O X/ O <br />Note: The only operations not required to provide enclosed booths <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 /> Approved bottled water. <br /> On-site hose bib that is connected to a potable water source. <br /> Other (specify):7^7 /Xfr <br />Electricity is provided for my booth's use: <br />' M ““ h°“”S <br />1 a!T Pr_ovid'n9 lhB Allowing hot temperature control for ths hot holding of all potentially hazardous foods above <br />I r“.