Laserfiche WebLink
__ Date(s): 7- // <br />2. <br />3. <br />4. <br />5. <br />6. <br />Jeu <br />7. <br />8. <br />9. <br />Page 7 of 11 TEMP EVENT APP <br />EHD 16-02 <br />7/28rt0 <br />^$37-7 <br />gvy-74^3 <br />/ Lv7Z~i^y- <br />meate, tamales, cooked beans, rice, <br />Name of organization/business: <br />Address: <br />TEMPORARY FOOD VENDOR’S APPLICATION <br />to return a signed and coveted copy of this checklist to <br />1. 1. Name of Event PQ < ___________ <br />The following is information about my organization/business: <br />Yonry Jce oP <br />Or. <br />Pfl0ne: < 6^81Uc? Altefnate;( <br />List food to be sold or given to the public: S h/7 l/-fX 1 CC. <br />I am providing food that is NOT prepared at home: 0Yes No <br />All food is prepared on-site or is from approved commercial facilities: E Yes No <br />Name of facility: . On Sl4C Phone: f ) <br />Address of facility: '1 1 --------------—— <br />fs/2sT"d7,«p7'o7 w'hthB‘^1^r^<,o':TOteot"iy'jnPS0,a^ea’a<xisi,5tffoo*pr'sPara‘r“’s™‘«f«'"w«>. <br />and fine mesh fly <br />arScJthe pX^ acceptable> ano^nstructedlo sjarlte foodTn“ food pJaE <br />S Other (specify): iQzCV'g l' <br />Note: The only operations not required to provide enclosed booths are those which sell beveraoes from <br />approved dispensers, or prepackaged foods from approved sources. leverages from <br />Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods: <br />P Approved bottled water. <br /> On-site hose bib that is connected to a potable water source. <br />® Other (specify): 5^^ X- <br />Electricity is provided for my booth's use: Yes No <br />' xTs “h Mdin3 °f poMi* <br />1 P“d,"S>316 “°«"s “ Bmpemlw conW for the hoi holding of ell polenMIy hezerdoos foods store <br />O Camp stove stemo & hotel trays <br /> Double steamer Steam table & lids <br /> Electric stove top ^.Other (specify) /V/-A- <br />Note: Examples of potentially hazardous food include- <br />vegetables, potato salad, eggs, and dairy products.