Laserfiche WebLink
TEMPORARY FOOD VENDOR’S APPLICATION <br />Date(s): 1. <br />2. <br />Address: <br />Phone: <br />3. <br />4. <br />1 <br />5. <br /> Other (specify): <br />6. <br /> Other (specify): <br />7. <br />8. <br />9. <br />meats, tamales, cooked beans, rice, <br />TEMP EVENT APPPage 7 of 11EHD 16-02 <br />7/28/10 <br /> Camp stove <br /> Double steamer <br /> Electric stove top <br />Note: Examples of potentially hazardous food include: <br />vegetables, potato salad, eggs, and dairy products. <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 />O' Sterno & hotel trays <br />0] Steam table & lids <br /> Other (specify) <br />I am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br />135°F: <br />List food to be sold <br />C'-euich^ <br />I am providing food that is NOT prepared at home: H'Ves No <br />All food is prepared on-site or is from approved commercial facilities: <br />Name of facility: _ <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 />du^i and the public) <br />0 A 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 tne public. <br />H No <br />AfyJfoved water for drinking, utensil and hand washing will be provided in my booth by the following methods: <br />Gp Approved bottled water. <br /> On-site hose bib that is connected to a potable water source. <br />Electricity is provided for my booth’s use: Yes <br />I am providing an accurate probe thermomaer to measure the hot and cold holding of potentially hazardous <br />foods during all times of booth operation: H Yes No <br />Alternate: arm X^S~-O?35 <br />1 to 5 <br />[2zYes No >- <br />gj Yes No <br />_ Phone: £ <br />Ail 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 />TName of Event: y \ in rKn u <br />The following is information about my organization/business: <br />Name of organization/business: <br /> <br />or given to the oublicTT <br />7<XC>3 f (kTy,