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I_ i <br />Nsrre cf o'canizs:'cn b„s less <br />Pnc'e: <br />• i □’r’er ;scec fy >: <br />on <br />.pp-cved oo“'ed /.-ater <br />3 <br />“ — -J 1 <br />5 <br />W. S'e'fiC' i -3:el ra.s <br /> Stesn -.sz - 3. i is <br />~i Otier 'spec -y: <br />I ar provding a booth with the fe'iowirg :';o p-ote:‘. ny Lipaskageo food a'.d fooa p"epa:a:io~ areas 'rin r.es <br />d jst and the pub: o) <br />TEMPORARY FOOD VENDOR’S APPLICATION <br />( <br />I am prcvid ng food that is NOT prepared at -o'-ie v es l2 No <br />Al' food s orepared on s te or is ‘'orn apoT /ed oommeroia: fao: oes TZ Ves -Ll ‘b <br />Name of fac'ity.Pi <-ne <br />Address of facility: <br />I a'" providing ar accurate prose thermometer to measure toe -ct and sole i-olding z: potertiai.y haza-dcus <br />■oocs du-hg all times of booth epe'atien: Yes P No <br />Note: Tne or.'y operations rot -equ.red to p-cvice enclosed booths are those wh ch sell beverages <br />approved disperse's or p-eoackaged foods '-on approved so-rces <br />Note: Examples of potentially hazardous food include; <br />vegetables, potato salad, eggs, and dairy products. <br />i j On-site hose oib that s conneotec to a potab e ater source <br />2f'Other (specify) PoHccblelUaier <br />Elect.' o.ty is provided for my booth's use' (Yes No <br />' Na-re of Event: <br />Zj Ca^'p stove <br />L? Do.;b'e steamer <br />E ec" ; stove too <br />I am c-ovi: ng the fol ow ng hot tempe'atu'e comm! m- the -ot noldl-q c- all potemia !u haza-dous foods abc.-e <br />135:F. <br />Approved oaterfor drinking utens and na'd wasmrg II be provided in my zoom cy t-e ’o' o/.-i-g metnoos <br />2: A boo?' with .vat’s and oe -g co-stmoiec of ormer .vood canvas, plastic, simi ar meter a a-c f re mesn •? <br />screening completely enclosing open food a'aas. It .vili also have a smooth ana cteanabie 'loo' monorete. <br />asphalt ciear ta-ps ard smooth wood are acceptable) and oonstmeted to sepa-a:e food and food p'epa'aticn <br />areas from tne pubi c <br />meats, tamales, cooked beans, rice. <br />Alternate: • ■ <br />GarLLc.-Fties>mp..( <br />All food vendors (both for profit antJ * f and complete? c::;,Z <br />The fol owing is irfcrmat:on abort m; crgo-.zation.Pusmess <br />Ud oocVieJ s. VveSh C^Ach <br />7_Lt& &ourzJru c^cl Merced., Ca <br />Lct'ooc ::: co id or . . . o , c 1^1, sVt )