Laserfiche WebLink
TEMPORARY FOOD VEINDOR'S ,APP CATION <br /> 411 food vendors (both for profit and non-:--:- _ ___ c return a signed and completed copy of this checklist to <br /> the festival coordinator three(31 v✓ee!s psi _ <br /> 1. 1.Nacre of Event: L Da•; : ' 7j <br /> ---- <br /> 2. The following is information a out my or nizationlbusiness: <br /> Name of organizationtbus;ness S / { <br /> Address L-A <br /> Phone: 'q A Ca Alternate: _-_- <br /> 3 List food to be sod cr giver,to the pubic: <br /> 4. I am providing food that is NOT prepared at home.10 Yes ❑ No <br /> All food is prepared on-site or is from approved commercial faci!itiesYes Q i�tQ 5 <br /> Name of facility. Al/Phone ( /��( a tece`� <br /> Address of facility: <br /> 5. 1 am providing a booth with the following: (to protect my unpackaged food and food-preparation areas from flies. <br /> dt.,st and the public) <br /> NKA booth with walls and ceiling constructed of either wood, canvas, plastic, similar material and fine mesh fly <br /> Greening, 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 /> 5- 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 /> 7 Electricity is provided for my booth's use:I;iUes❑ No <br /> 3 1 am providing an accurate probe thermometer to measure the hot and cold holding of potentially hazardous <br /> (cods during all times of booth operation: i'Y✓Yes C No <br /> B. 1 am rcividing the fol ovring hot temperature control for the hot holding of all potentially hazardous foods above <br /> 135'F: <br /> camp;love �14Stemo& hotel tr ava <br /> Double steamer team table&lids f <br /> Electric stove top `l'-T ther(specify) 4 Gct,� <br /> Note: Examples of potentially hazardous food include: meats, tamales, cookgd beans, rice, <br /> vegetables, potato salad, eggs, and dairy products. <br /> =_M7 15-02 P 7'�f 11 TEMP EVEN-A=? <br /> i All <br />