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tJ <br /> W <br /> O <br /> �. rWyy <br /> TEMPORARY FOOD VENDOR'S APPLICATION <br /> All fold vendors(both for profit antl non-profit)are requited to return a sighed and completed copy of this ctl&Ansl t) <br /> the festival coorditatwIhree(3)weeks prior <br /> 'to/this event <br /> 1, I blame ai EvCn4, - y�C�4t Dale(51 y. � <br /> 2 The Wlowing is information about my organizalwlvbuslrress. <br /> Name of orgWizatlorubu$rness <br /> Address f- l ? ? <br /> Phone '" .���- *76'k- _ Agernale.[ eJ <br /> 3 List food to be sold or given to the public d�a& z <br /> 4 1 am provldtng(cod that is hW prepared at home X Yes 0 No <br /> All f0od is prepared on-sae or is from approved commercial fawfhe5-P,Yes❑No <br /> Name of facility Phone <br /> Address of faddy ? <br /> 5. I am pro rridmg a truum wlh the toflo"(to protect my unpackaged food and food-preparation areas from flies. <br /> dust and the public) <br /> ❑A booty with walls and ceding constructed of anhef wood,canvas.plastic sander material and fine mesh fly <br /> scievnN.completely anctostrrg Open food areas IL will also have a smooth and cleanable floor(Concrete, <br /> e50aft clean tarps and Smooth wood are acceptable)and constructed to Separate food and hind Preparation <br /> areas from the public <br /> KOther(specify) <br /> Nate:7fte only operations not required to provide andosed b0oth5 are It1u5e which said beverages horn <br /> 3 <br /> approved dispensers,of Prepackaged foods from approved sources. ?> <br /> 6. Approved water fordrarking,utensil and hand washing wdi be provided in my tooth by the rolfowiog methods <br /> ❑Approved bottled water. 502 <br /> ❑On-site hose bib that is connected to a potable water source lyfD <br /> []Other(speciNl: <br /> 7 Eiedncdy is provided for my booth's use.-❑Ye Krgo <br /> 6 I am peavaling an accurate probe MermOmeter to measure the hot anti cold holdvey of potent, hazam0us <br /> - foods during E. <br /> city tastes of <br /> boom Operaoon []Yes LWVI No <br /> i <br /> B 1 era pmvrding the following bird temPeratune GOW01 for The hot holdaN of all poterrlally hazardous twds above <br /> if 135'F. r+v <br /> ❑Coop ao,e ❑stemo&hotel hays Cr <br /> ❑Double srearner ❑Steam(able a lids <br /> ❑Llecrnc Shiva trip ❑Other ispecrty) <br /> Not&: Examples Of potentially hazardous food include, meats, tamat&s, cooked weans. rice. <br /> J]]j. ve9agt>aes.Potato Wad.epga,and danry products, cooked <br /> l3 oar <br /> - <br /> W `� <br />