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TEMPORARY FOOD VENDOR'S APPLICATION <br /> 411 flood ver�ors(both for Fcoft and non—profit)ame reored to return a signed and completed copy of this cheil<W to <br /> the testiv*coordlretor three(3)weeks prior b. Mis went. y <br /> 1, 1.Name of Eva,6 Va`l fe �4 ���1 ki <br /> ?. i f ie following is irsfarMatio Pa Der r nIzeettkWbusiness /�7 t - /7/, /a S <br /> Narre cf org3nimb"Usilm,.�-5-6v <br /> Ad ress uQs 5 / �[.,_ � 1� es o-- -- 3 --- <br /> phone: 20cl)_(OCQ- tyvl� - <br /> f1::.�. <br /> 3 L at`.oCd:o Ze scid er gr.en to Hhe grub c �c�f,;�S r c iP.CC►��A _ �_�u � f' ;��5 <br /> 4. l am P-cv dhg food mat is UZ prepared at ttee: +;1 Y-- No <br /> M food is prepared on-site or is from approved=-unercial faci! ies: Yes.rl Nzi <br /> Name of f kc-22y. T __-- Phone f l <br /> Address of --- <br /> 5. !am providing a b c4h with the io;o_ir�g:(�to prol"te_�t my unpackaged'ood and food-prepa afion areas from Nes. <br /> Camq and the public) <br /> boa,*i with tmlfs ar d ceiiing cortstructed of eitl_ mod, zwms,plastic. skmilar rnateria'and firs mesh by <br /> .reening, completely erciosing open food areas- !t eiff a!so Lave a smith ana cte8:1aole floor (noncrete, <br /> Isp-liatt,clear, :arps and smooth v.-W are acceptable)and ac-lst1kitted 10 sepanate fbod and fo od preparation <br /> areas from tile PuNic. <br /> i7 Omer(spevfy)_ <br /> Note: The on;y operations not requited to p!ovgde enclosed "bs are dose %rhich sel: beverages from <br /> approved disuense s, or prepackaged It-ods.tcm ap:roved sources. <br /> 6. Approved water f T drinking,utensil and hand washing tyili be provided to my boo-V,lay the foil-owing methods: <br /> �App`*Vved bottled iria:er. <br /> t.;On-site nose bit:that is connec ed!o a ao.ab e ,Tatar sour d <br /> Other(specify): ---- <br /> 7. Electrick is provided for my booth's use Yes (- !.a <br /> S. I ar`s proMing an accurate urnl e!moer to rneasure the ^o± and cold �cldirg of poterti 'y hsdou5 <br /> foods durlrtg all d.-nes cf bwt aperrt c.-1 Y_s <br /> ?. 1 air, proaAemg the fof z�Ang hc: nr.ipera;; e c ontrc!for the . w` v)ldmg of all poten5a!ly hazani us foods above <br /> 135T. <br /> Camp stove "Ste.no&r:otel ways <br /> Doubie stem'-er Stern table&DIS <br /> Elect--stove top Other(Specify" `KCO C,flr- <br /> Mote: Examples of potentially hazardous food ircfude: pleats, tamales. cooked Loans, rice, <br /> vegetables, potato salad, eggs,and dairy procuc,s. <br /> Z <br />