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<br /> TEMPORARY FOOD VENDIORS APPUCATION
<br /> �a sicre an- ofthis ch, cklistt All food vendors (both profit an M
<br /> .he
<br /> 1,Na-re of Event:
<br /> I The 11n,14"DIVI-lig is!r.'Crrnat'ion aboc-r' my
<br /> Narre Cf OW Af V
<br /> C4- zfz-
<br /> Phons: _Q 3 9
<br /> 1 ant prcvid;-ig food tra: is NOT creo.arec nt r ez ND
<br /> Alf food ifs orepared or Ls to or:s
<br /> NaMe Cf f3Cil tV: 1)e_lj6-it Phone LS-Sf -7 (a.//—� - &P&-
<br /> 5 f am. prov!'ding a bocth ,,-MVI fbef:):1 owe t'g "",0 p"n"e:t my L;-I;)a:kP-qecj fc,:,,J aid fa= p:i�pa,rafion areas fr:)-n
<br /> '—'s: and :!-e pub'icl
<br /> A bsc: and ce !ng of e;:-er vvo:'d, Can'res, plastic, simFar matena-I and`Te mesh f'y
<br /> "_'!Y en--'Oslrig op---,, %,od areas. It w;II also f,,Bve a smooth, and clea,*Iable "oar (aonorete.
<br /> asp')n'* n-d -srriocth wozdarn,acceptable) and ccnsz7,.;c'ell to sapa.-are food and i0odp7-eparation
<br /> Note: Tne or,'y operations ^ot ;-=qu:,ed to vide erioloseJ booths W-; '17:SC v,'h:ch se-11 b �age-3
<br /> approved disPeinsers, -,-prapa*aped foods'-om approves sources
<br /> 5. A:),^roved-,%-ater for drin�drq utens:!and na7d w2s7;rg ,,,Tbepmrovided in rry boOt'" :'y tne
<br /> Apn--ved oot fed water,
<br /> On-site hose nib that�s connected to a.p;)tab e v,-ater source.
<br /> 7 0-1-1 er 1 lspecify):-
<br /> Electricity is provided for my use- E-:--Iyes❑ No
<br /> R. I ain, providing an accurate prole therniometer to measure tie hot and sold �oldirg o- po:e':t;ally hazardous
<br /> all tinnes of b:*th cpe7aticn: '1/t°es [: N:)
<br /> 1 arr the- foi.'ov ng to, mPe-at,.7a--or,trol for the hold;nqc- all poten:ia"y hazardous foods tot-e
<br /> 135T.
<br /> ca--,L,s"ove[7 71 S,ea,
<br /> F--, 7 S*ove tCp Jn-"O t'I e r C)V 00
<br /> Note: Examples of potentially hazardous food include: meats, tamales, cooked beans, rice.
<br /> vegetables, potato salad, eggs, and dairy products.
<br /> 0" A- 6"6o c4mA-A.)c,o 5,'rUe,
<br /> 3 64k C,14- lc�i c.ai7 9 LIM'4-0 P
<br /> 36t,12--j(LZ-rZP
<br /> riU 6-0 FtAA;4 O
<br /> 3 A-,-7*ac.#A,, 3ar- v a- U L' Ph-77 Y L L Zkt5-A----'6,41A-004)
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