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TEMPORARY FOOD VENDOR’S APPLICATION <br />1. <br />2. <br />Address: <br />Alternate: ) Phone: <br />List food to be sold or given to the public: 3. <br />4. <br />5. <br />6.Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods: <br /> Approved bottled water. <br />7. <br />8. <br />9. <br /> Camp stove Sterno & hotel trays <br />Double steamer Steam table & lids <br />I am providing a booth with the following: (to protect my unpackaged food and food-preparation areas from <br />flies, dust and the public) <br />I am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br />135°F: <br />Other (specify)Electric stove top <br />Note: Examples of potentially hazardous food include: meats, tamales, cooked beans, rice, vegetables, <br />potato salad, eggs, and dairy products. <br />O On-site hose bib that is connected to a potable water source. <br />'/2^'Other (specify): A-/ <br />Electricity is provided for my booth’s us^TJ YesJ/f 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: Eks N<C <br />The following is information about my organization/business: <br />Name of organization/business: iC/l! 'HA. f <br />2^7 ) JW"- <br />I am providing food that is NOT prepared at hom£l OYes No <br />All food is prepared on-site or is from approved commercial facilities^ Yes No <br />Name of facility: Vlc/o^N yl/M <br />Address of facility: <br /> 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 the public. <br />J^^bther (specify): <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 />5 <br />All food vendors (both for profit andTon-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:Date(s):