Laserfiche WebLink
TEMPORARY FOOD VENDOR'S APPLICATION <br /> �I <br /> All food vendors (both for profit and non-profit) are required to re:urn a signed and cor,pteted copy of this checklist to <br /> the`estival Ganrdir�ator Three(3)ee:<s prior td'h�is�sv,ent <br /> 8 r'8 Of \+e lt: G1 a Lt- t V y�+1 U�f Dctw;,Sj <br /> 2. The following is information about my orgai n:zation;business <br /> Name cf organizationibus�ness',,-���v�t��5� -� `• o� �� --e5 <br /> Address i_Z y W A- G-FI - ry'f"�G �f c,� C# � a L y <br /> Phone: ,off/ A11.9mve: t' ? <br /> List foci:o cc sc;d ct :a'"4u`.;°u �'T� C `�=3 <br /> 1' - <br /> 1 arf prcvidmq food that is NOT oreoweo at nome. 5-Yes ❑ 'do <br /> Al!food is orepared on site or is from approved co"merciai faci':ies n Yes atly <br /> Name of facility � Phone <br /> Address of fa2vhzy. ___-_ <br /> 5 1 am providing a booth with the follow irg (o pro:ec'. my unpa:kaged food and food-p-eparation areas fr= Pies <br /> d.ist and the public.) <br /> ;?A,booth with ,.ails and ceiling cons rutted of eit~er wood, canvas, plastic, similar material and fire mesh f'y <br /> screening completely enclosing open food areas It will also have a smooth anti cleanable floor (con^rete <br /> asphalt, clean tarps and smooth Wood are acceptable) and constructed 'm separate food and food oreparation� <br /> areas from the public <br /> J Omer%specify): <br /> Note: T'ne only operations not required to prcvide Enclosed booths are those vrh!ch sell beverages from <br /> approved dispensers o-prepaskaged foods from approved sources <br /> 3 AP.-roved water for drinking, utensil and"lad*esning wl!be prow idled in my boo;h ny the`o!lowina rr;-M`o Js <br /> App-dved tooled viater <br /> i-1 On-si',e hose oib that is co-inected to a ootabie r✓afrr source <br /> 0:11er{specr,-y; <br /> E)ectricity is provided for my booth's use- j"-Yes [i No <br /> 3 1 an providing an accura:e probe thermometer to measure the net and cold `'oldirg o-po:ant:ai y hazardous <br /> 'Cods du-ina all tiles of booth operatic-1.I— Yes ff_ho <br /> 9 1 arr, nroviomg,he fo!'ov,ng hot .er-pe-atura con:rcl `or the hot holding of all potenaafiy t?aza.d:-i;s foods aocee <br /> 1 ,55 z F. <br /> :.C1�1i-'StL7�+'V Ste-no a }.�! ors <br /> C Do::4_ steamer ❑steam:a Ie 3 i d3 <br /> F7 r- s,ove tcp Otner rspecAp <br /> Note: Examples of potentially hazardous ;ood include: meats, tamales, cooked beans, rice, <br /> vegetables, potato salad, eggs, and dairy products. <br />