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a <br />I <br />Dafefs): 1, <br />2. <br />3. <br />4. <br />5. <br />a <br />7. <br />8. <br />9. <br />meate, taraatoa, cooked Swans, rice, <br />Paa*7 of 11 -rapsf»TAM> <br />L <br />&oteM <br />(M/ct/is <br /> Stemo&lw Set trays <br /> Steam table A Ms <br /> Other (specify} <br />jil <br />Xk B-5 <br />)---------------------------------- -- <br />foods during aR ttmss of booth oparatforc Yei No <br />I am provtdtog tt» fottowing hot temperature control for the hot holding of aS potenBefly hazardous foods above <br />135“F: <br /> Camp stove <br /> Double steamer <br /> Electric stove top <br />Note: Examptee of potentfolly hazerdoua food Indude' <br />vegetable*, potato sated, «99*> «">■* daily product*. <br />?S/-/<75 , <br />burton r/. ?«/o <br />TEMPORARY FOOD VENDOR’S APPLICATION <br />Ail food vendors (both forprafll and non-profit) are required to return a signed end completed copy of this checWst to <br />the festivel coordinator three (3) weeks prior to this event. <br />1, Name of Event AfU <br />The foltowing is fnformaliorr about my wganlzationAMSIness; <br />Name of organlzaticn/buslness:. Ameziri ajafe- <br />Address: I ^ lo \ Arrh___kd£—J. <br />Phone: ^L/------------ Atemataf <br />List food to be sold or given to the public: <br />1 am providing food that is NgT prepared at home: 0 Yes No <br />All food is prepared on-site or fe from approvedcommercial facdritfes: 0Ves O No <br />Name of facility; Aw/iffl., ---------^>PhoneiLZ£L. <br />AddressnffariHty, (SM <br />I am providing a booth with th© foflowlng: (to protect my unpackaged food and fcod-prepwafen areas from toes, <br />dust and the pubic) <br /> A booth with waBs and cettng constructed of either wood, canvas, ptaafic, simter material and fine mesh fly <br />screening, comptetety enclosing open food areas, ft will ateo haw a amoofh and cteanabte tear (concrete, <br />asphalt, dean tarps and smooth wood are aoceptable) and constructed to separate food and food ixepwatfon <br />areas from the pubfto. <br /> Other (specify): ....„ ------------------------------------------ <br />Note: The only operations not required to provide enctossd boodis are those which safl beverages from <br />approved dispensers, or prepackaged foods from approved souroea. <br />Approved water for drinking, utensil and hand wasNng wN ba provided in my booth by tha folkwtng methods: <br /> Approved bofliad water. <br /> On-altB hose Mb that Is connected to a ptriaMe water source. <br /> Otoer (specify): ... - J/l ---------------------------------------------- <br />Electricity is provided foe my booth's use: Yas Q No <br />I am providfog an accurate probe thermometer to measure the hot and cold holding of potentially hazardous