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TEMPORARY FOOD VENDOR’S APPLICATION <br />2. <br />Phone: <br />3. <br />4. <br />5. <br />6. <br />7. <br />8.the hot and cold holding of potentially hazardous <br />9. <br />meats, tamales, cooked beans, rice, <br />Page 7 of 11 TEMP EVENT APP <br /> Camp stove <br /> Double steamer <br /> Electric stove top <br />0Sterno & hotel trays <br /> Steam table & lids <br /> Other (specify) <br />Note: Examples of potentially hazardous food include: <br />vegetables, potato salad, eggs, and dairy products. <br />Electricity is provided for my booth's use: <br />EHD 16-02 <br />7/14/15 <br />are those which sell beverages from <br />EEfYes No <br />I am providing an accurate probe thermometer to measure <br />foods during all times of booth operation: Yes No <br />1 ar? Pr°vidin9 the following hot temperature control for the hot holding of all potentially hazardous foods above <br />IOD r". <br />All food vendors (both for profit and non-profit) are <br />the festival coordinator three (3) weeks prior to this event. <br />1. <br /> ___________Phone: <br />^^0/ U CiA <br />' ^sTand the pubfof f°li0Win9: (t° prOtect my unPacka9ed food and food-preparation areas from flies, <br />0 A 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 />area^fromthe ^pubHcand W0°d acceptable) and construc{ed to separate food and food preparation <br /> Other (specify):________ ______________ <br />Note: The only operations not required to provide enclosed booths <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): <br />required to return a signed and completed copy of this checklist to <br />1 Name of Event: Date(s): ZclL <br />The following is information about my organization/business: <br />Name of organization/business: 0^ <br />Address: <9 Bcft Q &/ <br />) TM-OW_______________ Alternate;^) <br />List food to be sold or given to the public: , JV/CtT, <br />I am providing food that is NOT prepared at home: EfYes Q No <br />All food is prepared on-site or is from approved commercial facilities: EfYes O No <br />Name of facility: Phone: <br />Address of facility:.