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TEMPORARY FOOD VENDOR’S APPLICATION <br />i __Date(s) <br />2 <br />Address <br />Phone ) <br />3 <br />4 <br />5 <br />meate, tamale*, ceokact bean*. rtca» <br />v^taMw, potato aatod, aftga, products. <br />Name of orgamzabon/busmess <br />jy <br />The following is information about my organization/business <br />i Bu <br />H S3 BrtAytffOT <br /> Other (speafy):____________________ ________—------------------------------ <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 />Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods <br />Approved bottled water. <br /> On-srte hose bib that is connected to a potable water source <br />All food vendors (both for profit and non px z are required to return a signed and con ted ccpy of this cher>list to <br />the festival’cooidioator three (3) week* pnor io this event /I , j <br /> 1 Name of Event Dalets, 7/7:^ <br />•out my organization/business <br />I. i. <br /> <br />booth with walls and ceiling constructed of either wood canvas, plastic, similar matenai and fine mesh fy <br />Screening, completely enclosing open food areas. It will also have a smooth and cleanable floor (concrete <br />asphalt, dean tarps and smooth wood are acceptable) and constructed to separate food and food preparation <br />areas from the public <br />L f - +. <br />A ternate ( <br />r' Pl ¥ <br />tPmeasure the hot and cold holding of potentially hazardous <br />foods durino sM tknss of booth operation* P^Yos (71 No <br />l am providing the foiowtng hot temperature control for the hot holding of all potentially hazardous foods above <br />135T _ <br /> Camp stove Stemo 4 hotel trays <br />O Double steamer ^5 Steam table & lids <br /> Electric stove top O Other (specify) <br />Note: Examples of potentteMy haxardoue food Include: <br />List food to be sold or given to the public ’ ‘ , <br />S> Ofl 7* ‘ •< » > . ■»• <br />I am provding food that is NOT prepared at home [^Tes No <br />All food is prepared on-site or is from approved commercial fac.il ties £K.Yes [ ] No <br />Name of facility lAjjA ~ Phone (£ <br />Address of facility _________ <br />I am providing a booth with the following (to protect my unpackaged food and food-preparation areas from flies <br />dust and the public) <br />6SE Hazelton Avenue | stecKton. Calitomia 9520SI 1^209 468-34201 F 208 464-0138 I ww <br />J 16-02 *** <br />J/17