Laserfiche WebLink
1. <br />2. <br />3. <br />4. <br /> No'es <br />kaged food and food-preparation areas from flies, dust and the public by the <br />5. <br />6. <br />8. <br />9. <br />Page 1/2 Rev 07/28/2017 <br /> Electric stove top <br /> Other (Specify) <br /><52^ I ~4- <br />vendors nJt?n c^iffc^n'bX Skffithe show. <br />All food vendors (both for profit end non-profit) ere required to return a signed and completed copy of this checklist to <br />Name of Organizabon/Business: <br />Address: ^0 L—A. <br />Phone: ^2-^- <br />List food to be sold or givgn to the public: *6^ <br />I arff providing foods that are not homemade: tzTYes U NO <br />All foods are prepared on-site or are from approved commercial facilities. E <br /> Name of facility: ----------- <br />E.H. Permit #:---------------------------------------------------------------- <br />PTApproved bottled water <br />□4Hose-bib on-site at the festival. <br /> Other (specify):----- ------------------------------------------------------- <br />Electricity is provided for my booth’s use: Q^es □ No <br />I am providing an accurate probe thermometer to measure the hot and cold holding of potentially hazardous <br />foods during all times of booth operation: Yes No <br />providing the following hot temperature control for the hot holding of all potentially hazardous foods <br />• 91B-37D-3647 phone • 209-234-178 <br />I am protecting my unpacl <br />following methods: <br />(J^booth with walls and ceiling constructed of either wood, canvas, plastic, similar material and fine <br />mesh fly screening, completely enclosing open food areas. <br />O<A booth with a smooth and cleanable floor (concrete, asphalt, clean tarps and smooth wood are <br />acceptable). <br />0Abooth constructed to separate food and food preparation areas from the public. <br />1=1 Note- the^sn^y operatloite 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 />the festival organizer two (2) months prior to this event. <br />NameofEvent lfaAate(s): W (y I - <br />The following is information about my organization/busmess: <br />--------------___ <br />Ca bxA rg 4 <br />Alternated-_____________ ___________ <br />I am <br />‘above 140° F: <br /> Caprp stove O Double steamer <br />□^terno & hotel trays Steam table & lids <br />Note: Potentially hazardous food examples: meats, tamales, cooked beans, rice, vegetables, potato <br />salad, eggs and dairy products. <br />ven (lor5* SanJoaquinAspaiagusFeslival.net