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TEMPORARY FOOD VENDOR’S APPLICATION 2. 3.z 4. 5. Other (specify): Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods:6. O Approved bottled water. 7. 8. 9.[ Of aH potentially hazardous foods above Camp stove Double steamer Electric stove top I am providing the following hot 135’F: I am providing an accurate probe foods during all times of booth of Note: The only operations not required to provide enclosed booths are those which sell beverages from approved dispensers, or prepackaged foods from approved sources. t I am providing a booth with the following: (to protect my unpackaged food and food-preparation areas from flies, dust and the public) P^A booth with watts and ceiling constructed of either wood, canvas, plastic, similar material and fine mesh fly screening, completely enclosing open food areas. It will also have a smooth and cleanable floor (concrete, asphalt, dean tarps and smooth wood are acceptable) and constructed to separate food and food preparation areas from the public. On-site hose bib that is connected to a potable water source. Bother (specify): 1<^/S Electricity is provided for my booth's use: H^Yes ■ AH food vendors (both for profit and non-profit) are required to return a signed and completed copy of this checklist to the festival coordinator three (3) weeks prior to this event. 1. 1. Name of Event: fUslIf The following is information about my orgamzation/busmess: Nameoforganizatfanrtjuslness: Z X Address: Phon®: Alternate: ( ) List food to be sold or given to the public: d//S^ ft ftp 4 I am providing food that is NOT prepared at home: Q Yes (ZfNo All food is prepared on-site or is from approved commercial facilities: 0/Yes No Name of facility:Phone: ( ) Address of facility:__________________________________ _______________________ Date(s): and cold holding of potentially hazardous