Laserfiche WebLink
TEMPORARY FOOD VENDOR’S APPLICATION <br />’ Mi (UWOrJA <br />//V/Date(s):1 .Name of Event: 1. <br />2. <br />Nameoforganization/business: <br />Address: <br />) Phone: <br />List food to be sold or given to the public: 3. <br />4. <br />1 <br />5. <br /> Other(specify): <br />Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods:6. <br />[3 Approved bottled water. <br />[3 On-site hose bib that is connected to a potable water source. <br /> Other(specify): <br />Electricity is provided for my booth’s use: H Yes No7. <br />8. <br />9. <br />food include: meats, tamales, cooked beans, rice, <br />Page 9 of 11 <br />Note: The only operations not required to provide enclosed booths are those which sell beverages from approved <br />dispensers, or prepackaged foods from approved sources. <br />[3 Camp stove <br />[3 Double steamer <br /> Electric stove top <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 />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: [2 Yes |3 No <br />Note: Examples of potentially hazardous <br />vegetables, potato salad, eggs, and dairy products. <br /> Yes No <br />_Phone: ( <br />[2 A booth with walls and ceiling constructed of either wood, canvas, plastic, similar material and fine mesh fly screening, <br />completely enclosing open food areas. It will also have a smooth and cleanable floor (concrete, asphalt, clean tarps and <br />smooth wood are acceptable) and constructed to separate food and food preparation areas from thepublic. <br /> Sterno & hotel trays <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: <br />Name of facility: /£///?_______________________ <br />Address of facility:3__________________________ <br />|3 Steam table & lids <br />[2 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 />All food vendors (both for profit and non-profit) are required to return a signed and completed copy of this checklist to the festival <br />coordinatorthree (3) weeks prior to this event. <br />The following is information about my organization/business: <br />C) H <br />____ <br />Alternate: (