Laserfiche WebLink
2. <br />3. <br />4. <br />5. <br />those which sell beverages from <br />6. <br />7. <br />8. <br />7. <br />meats, tamales, cooked beans, rice. <br />Page 7 of 11 TEMP EVENT APP <br />EHD 16-02 <br />10/13/09 <br />O Camp stove Q Stemo & hotel trays <br /> Double steamer g steam table & lids <br /> Electric stove top other (specify) <br />Note: Examples of potentially hazardous food include: <br />vegetables, potato salad, eggs, and dairy products. <br />Date(s): 9^ Z3 2Jz> <br />TEMPORARY FOOD VENDOR’S APPLICATION <br />th'L farfi>V^ndOrSH'pr°^,and poH-Prafi*) 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 />1. Name of Event: VCa YA I ) <br />J ; <br />The following is information about my organization/business: <br />Name of organization/business:I <XCO Go <br />Address: 3£>3/ // Sr £<1C;4d, CA- <br />Phone: (Q ((g ) ^cA-O'—6->~~T Alternate: (l(o) $>3^ - <br />List food to be sold or given to the public: ~Th j <br />I am providing food that is NOT prepared at home: Ki Yes No <br />All food is prepared on-site or is from approved commercial facilities: [Jf Yes No <br />Name of facility: _______________________ ___________phone: ( } <br />Address of facility:.______ <br />With the followin9: (t0 Protect mY unpackaged food and food-preparation areas from flies, <br />Qusi ana ine puonc) <br /> A booth with walls and ceiling constructed of either wood, canvas, plastic, similar material and fine mesh fiv <br />screening completely enclosing open food areas. It will also have a smooth and cleanable floor (concrete <br />are^fronTthe pubHcand Sm0°th W00d ar® accePtable) and constructed to separate food and food preparation <br />JB'Other (specify): TAl/I Y/VrSK, <br />Note: The only operations not required to provide enclosed booths are <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):_______4- /V'/j f'J-A____________________________________ <br />Electricity is provided for my booth’s use: K) Yes No <br />I am providing an accurate probe thermometer to measure the hot and cold holding of potentially hazardous <br />foods during all times of booth operation: KT Yes No ’ <br />I, am providing the following hot temperature control for the hot holding of all potentially hazardous foods above