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3. <br />4. <br />5- <br />6. <br />7. <br />8. <br />9. <br />Date(s): /l7 | I2/?-/ l~J <br />TEMPORARY FOOD VENDOR’S APPLICATION <br />1. I.Nameof Event VVowAt^ C.Ms\s\va.^.s pewV <br />2. The fotowing is information about my organization/business: <br />Name of organizafon/business: R-OS^x S VSCARer^X <br />Address: 0.Q- *5 .3^A.O<C.$>ca<f~\ ^r\xz<— . g,<.^x\.o <br />Phone: (-ZpA).^3S--7II| Atenae^) t„ | <br />List food to be sold or given to the public: P<ASW<^>/ CpOk-K^ <br />• am providing food that is NOT prepared at home: CSYesCjNo <br />Al food is preparedon-site on’s from approved commercial facilities:]^ Yes No <br />AaxwsorfeiHy.aa.SI jarUion fivr, ' <br />' ’* ",e <l° P'°te“ "* unpacte‘se‘1 «' l^^on areas from flies. <br />- ™=h oy <br />XX'XX-1'’'1 “““’ " a°cepBbte’ - to separate <br /> Other (specify): <br />Noto: The only operations not required to provide enclosed booths are those which snll <br />approved dfspensers, or prepackaged foods from approved sowX beverages from <br />Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods: <br /> Approved bottled water. <br />O On-site hose bib that is connected to a potable water source. <br />Q Other (specify): <br />Electricity is provided for my booth’s use. Yes £(j\io <br />' ofpn^, ha^ <br />I the Mowing ha teraperatera conlral ter tee hot hnWing of a» pofenlially hnrardons fcc* abwe <br /> Camp stove Q Stem© & hotel trays <br /> Double steamer Steam fable & lids <br /> Electric stove top Other (specify) ^>CA.S\tV^S C\<C V <AV tLobW\ <br />"to*- <br />COMPLETE BOTH SIDES AND RETURN WITH EXHIBITOR AGREEMENT <br />cyA i Ci