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TEMPORARY FOOD VENDOWS APPUCATiON <br /> All food vendors(bar for profit and rao"ra )are regUWW 1110 tOWM a signed and meted sappy of Oft c h+ Aist to <br /> the festival coordinator three(3)weeks prior to this event, <br /> t t.Name of Event: `7 f ...iato(s). <br /> 2 The following is information about my orpnixa1ionlbusiness: <br /> ire of organizatits'rlbusinesa I. ' 0 b C <br /> Address: Zo iELLt>1FP-5gNjphorw <br /> Atternate <br /> � . ..... _.. .... <br /> � . <br /> 3. List food to be sow or givers to the public.. : tj C>W! �: <br /> 4. i am providing food that is NOT premed at home:dYes 0 No �,�' <br /> Ali food is prepared on-site or is moved c ommerc . r .d Ys 0 No <br /> Name of fac ibr -'iceP4K Phone, <br /> Address of <br /> S. I am providing a booth with the fol1owing:(to protect my unpackarged food and food-preparation areas from flies, <br /> dust and the pubic) <br /> booth with wails and ceiling ing constructed of either wood,canvas, plastic, similar material and fuse mesh fly <br /> ss ming, completely enclosing :`span fit 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 /> 06W(SpWift <br /> NOW The only operations not rewired to provide enclosed laths are #me wtfth sell beverages from <br /> approved dispensers,or prepackaged foods from approved sources. <br /> 6. Approved water for drink,utensil and hand wast tg w4 f be provided in my booth by the follovAng tr rods- <br /> &armed bottled water. <br /> [I Ott-site hose bib that is connected to a potable water source.. <br /> 0 Other(specify) <br /> 7. EkKAricity is provided for my booth's tow.des(l No <br /> S. I arm providing an agate probe them( to measure the hot and cold Molding of potentially hazardous <br /> foods goring all times of booth operation El No <br /> g. 1 am providing the following hot temperature control for to heat Molding of ail potentially hazardous food above* <br /> -i3 F: <br /> dcampstove [I Sterno&hotel trays <br /> [I Double steamer C]Steams table&lids <br /> 0 El trio stove top C3 tither(specify) <br /> Notes: Examples of potentially hazardous fbod Mode* meats, tamales, cooked beams, rice, <br /> vegetables,potato salad,eggs,and dairy Viaducts. <br />