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TEMPORARY FOOD VENDOR’S APPLICATION <br />1. <br />2. <br />Phono: <br />3. <br />4. <br />5. <br /> Other (specify): <br />those which sell beverages from <br />6. <br />7. <br />8. <br />9. <br />meats, tamales, cooked beans, rice, <br />TEMP EVENT APPPago 7 of 11EHD (6 02 <br />7/14/15 <br /> Other (specify): <br />Electricity is provided for my booth’s use^^Yes No <br /> Camp stovo <br /> Double steamer <br /> Electric stove lop <br /> Stemo & hotel trays <br /> Steam table & lids <br /> Other (specify) <br />Date(s) <br />Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods: <br />jM^Approved bottled waler. <br /> On-site hose bib that is connected Io a potable water source. <br />Note: The only operations nol required to piovide enclosed booths are <br />approved dispensers, or prepackaged foods from approved sources. <br />Note: Examples of potentially hazardous food include: <br />vegetables, potato salad, eggs, and daily products. <br />I am providing the following hot temperature control for th© hot holding of all potentially hazardous foods above <br />135°F: <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 operalion:^^Yes No <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 />booth with walls and ceiling constructed of either wood, canvas, plastic, similar material and fine mesh fly <br />screening, completely enclosing open food areas. It will also have a smooth and cleanable floor (concrete, <br />asphalt, clean tarps and smooth wood are acceptable) and constructed to separate food and food preparation <br />areas from the public. <br />All food vendors (both for profit and non-profit) are required to return a signed and completed copy of this checklist to <br />the festival coordinator three (3) weeks prior to this event. <br />1. Name of Event: <br />The following is information about my organization/businoss: <br />Name of organization/business:Wini&auWto - <br />Address: CA QW) <br />( ) Alternate: ( ) <br />List food to be sold or given to the public: OL C <br />I am providing food that is NOT prepared at home: Yes^No <br />All food is prepared on-site or is from approved commercial facilities: J^Yes O No <br />Name of facility:Phone: (1 <br />Address of facility: