Laserfiche WebLink
TEMPORARY FOOD VENDOR'S APPLICATION <br /> All food vendor(both for profit and non-profit)are rewired to return a signed and completed copy of this checklist to <br /> the festival coordinator three(3)weeks prior to this event. <br /> 1. 1-Name of Event =_�i���� v t "€ kc;:j Date(s) .. <br /> 2. The following is information about my ottrganizabonlbusiness: <br /> Name of organization/business: "i Vie, LDN1e- o <br /> Address: `7 0 -t>v-t ye � �> zime i t C A c ,5c2c <br /> Phone: ( ) • r E Alternate: t= ) l-� - <br /> 3. List food to be sold or givers to the public: 0hi i t i-�f2ren+ <br /> 4. lam providing food that is NOT prepared at home: Yes No CI►l'l rur � �= <br /> All food is prepared on-site or is from approved commercial facilities.-f&yes 0 No <br /> Name of facility; l ,i I; at ;' 6 ,t = Phone: (`jZ�1 �(a 2�� <br /> Address of facility: I �' vr' CA ':�l 2U <br /> 5. l am.providing a booth with the following: (to protect my unpackaged food and food-preparation areas from flies, <br /> dust and the public) <br /> Pq A booth with walls and ceiling constructed of either wood, canvas, plastic, similar material and fire mesh fly <br /> screening, completely enclosing open food areas. It will also have a smooth and cleanable floor (concrete, <br /> asphalt, clears tarps and smooth wood are acceptable) and constructed to separate food and food preparation <br /> areas from the public. <br /> Other(specify): <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 /> 6. Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods: <br /> Approved bottled water. <br /> C1 tin site hose bib that is connected to a potable water source. <br /> Other(specify): ' <br /> F. Electricity is provided for my booth's use:X Yes 0 No <br /> 3. 1 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 /> 9. l am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br /> 135'F. <br /> Camp stove F Sterno&hotel trays <br /> [ Double steamer r_1 Steam table&lids <br /> r_1 Electric stove sop �SDther(specify) a V n\c�>y-C) <br /> Note: Examples of potentially hazardous food include. meats, tamales, cooked beans, rice, <br /> vegetables,potato salad,eggs,and dairy products, <br />