Laserfiche WebLink
TEMPORARY FOOD VENDOR'S APPLICATION <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 <br /> 1pri r to this event. n 1 <br /> 1. 1.Name of Event: G V `' 1 ©ate(s): C/�� / 19L <br /> 2. The following is information about my organizationlbus;n ss: <br /> Name of organization/business: __=0 , lad " <br /> Address: rv <br /> �] <br /> Phone: 90q.) d- _ Alternate: (Wi) <br /> 3, List food to be sold or given to the public:TpACC 6 0 <br /> 4. 1 am providing food that is NOT prepared at home: es❑ No <br /> All food is prepared on-site or is firo3 approved com er 'al facilities: D'Yes ❑ No <br /> Name of facility: C. Phon r-- q j <br /> Address of facility:ll� 0_W :_(MAh\r,(aR <br /> 5. 1 am providing a booth with the following: (to protect my unpackaged food and food-preparation areas from flies, <br /> dust and the public) <br /> VA booth with walls and ceiling constructed of either wood, canvas, plastic, similar material and fine mesh fly <br /> screening, completely enclosing open food areas. It will also have a smooth and cleanable floor (concrete, <br /> asphalt, clean tarps and smooth wood are acceptable) and constructed to separate food and food preparation <br /> areas from the public. <br /> ❑ Other(specify): <br /> Note: The only operations not required to provide enclosed booths are those which sell beverages from <br /> approved dispensers, or prepackaged foods from approved sources. <br /> a. Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods: <br /> W/Approved bottled water. <br /> ❑ On-site hose bib that is connected to a potable water source. <br /> ❑ Other(specify): <br /> 7 Electricity is provided for my booth's use: Yes ❑ No <br /> 8 1 am providing an accurate probe thermomete to measure the hot and cold holding of potentially hazardous <br /> foods during all times of booth operation: Wes❑ No <br /> 9. 1 am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br /> 135°F: <br /> ❑ Camp stove ❑ Sterno&hotel trays <br /> Double steamer ❑ Steam table& lids <br /> f _J Electric stove top 6(Kther(specify) ` <br /> Note: Examples of potentially hazardous food include: 1 meats, tamales, cooked beans, rice, <br /> vegetables, potato salad,eggs,and dairy products. <br /> EHD 15-02 Page 7 of 11 <br /> 7128110 TEMP EVENT APP <br />