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TEMPORARY RARY PROD VENDOWS APPLICATION <br /> All food verxors{both for proft and astir ixuNiit)am required to reWm a skjned and completed copy of#is chwckftt to <br /> the festival coordinawr time(3)weeks prior to this event_ <br /> 1. Ii tft a of Event: %rL t n i 4 113 <br /> 2, The fol>mng is information about.my organi?ationAxfsirtess: <br /> l4arne&organization lousiness- VO. CI a f°1 - <br /> Address: <br /> Phone: (v '' } _ � - Alternate:[ } <br /> . List food 33P.X�� .sold orgiven to the public. M <br /> 4. 1.am providing food that is KOT prepared at horm-A Yes No <br /> All food is prepared on-site or is from approved c omrr wciai facie: Yes 0 No <br /> Name of facility: V0 Ut,ct Rhone:C-101 I ctS t <br /> Address of facility i�t C.6��. \ <br /> b. 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 /> F1 A Month with walls and ceiling constructed of either wood,canvas, plastic, similar material and fine mesh fly <br /> screening, completely enclosing open food areas. tt will also have a smooth and cleanable f m (concrete, <br /> asphalt,clean tarps and smooth wood are amble)and constructed to separate food and food preparation <br /> areas from the public. <br /> Note: The only operations not required to provide enclosed booths are those which seg beverages from <br /> approved dispensers,or prepackaged foods from approved sources. <br /> 6, Approved water for drinking,utensil and hand washing wilt be provided in my booth by the fang methods: <br /> []Approved battled water. <br /> On-site hose bib that is connected to a p wad scum. � rr <br /> (Specify): <br /> 4 tCa t� t i'Y1 V1 Sf r1a i SVAt�' <br /> 'tt (i 4,A <br /> 7. Etc�ctiic ty is provided for my booth's use: es <br /> � <br /> 8. 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:M Yes to <br /> 9. 1 am providing tine foffoMnq hot temperature cor*ol for the hot holding of all potentially hazardous foods above <br /> 135QF: <br /> rl Camp stove Q Sterno&heel two <br /> Bauble steamer El Steers tdt)Ie&lids h GA <br /> ©Electric stove top 0 Other( y) <br /> Note: Examples of potenba#ty his foOd include. meats, tamales, woired beans, rice, <br /> Vegetables,potato salad,eggs,and dairy prnduM. <br /> EHD 1"2 Page 7 d 11 TEMP EVENT RPP <br /> 7114115 <br />