Laserfiche WebLink
h <br />TEMPORARY FOOD VENDOR’S APPUCATION <br />i. <br />2. <br />Phone: <br />3. <br />?4. <br />5. <br />6. <br />7. <br />8. <br />7. <br />135*F: <br />meats, tamales, cooked beans, rice. <br />Pag&Tof it TEMP EVENT APPEHD 1S-02 <br />KT1M09 <br /> Camp stove <br /> Double steamer <br /> Bectric stove top OJ <br />45^Stemo & hotel trays <br /> Steam table & 6ds <br />(0-Other (spedly) <br />Note: Examples of potentially hazardous food include: <br />vegetables, potato salad, eggs, and dairy products. <br />Name of Event <br />The following is informatioty <br />I PlrdcVc^x <br />BWbooth with walls and ceisng constructed of either wood, canvas, plastic, similar material and fine mesh fly <br />Screening, completely endosng open food areas. It wtl also have a smooth and cfeanable floor (concrete, <br />. asphalt, dean tarps and smooth wood are actepfexe) and constructed to spparyte food aid food preparation <br />areas from the public. <br />O Other (specify): <br />Note: The only operations net required to provide endosed booths are those which sefl beverages from <br />approved dispensers, or prepacxagetj foods from approved sources. <br />Approved water for drinking, utensii and hand vrashing vwil be provided in my booth by the foflowing methods: <br />Vt/l Approved bottled water. <br /> On-site hose bib that is connected to a potable water source. <br /> Other (specify):_______________________________________________________ <br />Electricity is provided for my booth’s use: Yes <br />I am providing an accurate probe thermometer to measure the hot and cold holding of potentially hararrinus <br />foods during an times of booth operation^Yes No <br />I am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br />Name of organization/business: <br />Address: <br />.List food to be sold or given to the puruc: J <br />All food vendors (both for profit and non-profit) are required to return a signed and completed copy of this checklist to <br />the festival coordinator three (3) weeks prior to this event <br />ten TWy_______________Date(s): (YWxVy |8t 2_C)I £ <br />iy organizai^busjness: <br />yog <br /> Acemate: ( <br />I am providing food that is NOT prepared st home: 0Yes No <br />AB food is prepared on-site or is from ^spra^d commercial ssiSes.SfYi <br />Name of facility: /./ /____________________Phc <br />Address of facility:______________________>—— <br />I am providing a booth with the fixowng: (to protect my unpackaged food and food-preparation areas from flies <br />dust and the public)