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C'ut.c^s): 61. Name of Event: 1. 2. Address: ).Phone: List food to be sold or given to the public: 3. No4.!S 5. Other (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. ^^4 Steam Other (specify)Electric stove top TEMP EVENT APPPage 5 of 9EHD 16-02 7/14/15 I am providing a booth with the following: (to protect my unpackaged food and food-preparation areas from flies, dust and the public) tpres L_ Phone: ( I am providing food that is NOT prepared at homeQ All food is prepared on-site or is from approved commercial facilities: ------------------------------------------------- Name of facility: _ Address of facility: Note: The only operations not required to provide enclosed booths are those which sell beverages from approved dispensers, or prepackaged foods from approved sources. I am providing the following hot temperature control for the hot holding of all potentially hazardous foods above 135°F: No ) 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. I am providing an accurate probe thermometer to measure the hot and cold holding of potentially hazardous foods during all times of booth operation [IpYesQ No The following is information about my organization/business: Name of organization/business: M i 14^11Ce £. Ch ( Alternate: ( 'T/V Electricity is provided for my booth’s use^Ybs q No Sterno & hotel trays q-j table & lids LJ Camp stove I Double steamer