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aP22 017 imagel.JPG <br /> ­41i k a r`. K T'••'+17 r P . 'b fit,►` � <br /> TEMPORARY FOOD VENDOR'S APPLICATION <br /> All food vendors(both for profit and non-profit)are required to return a signed and completed copy of thr-,chorklv,l to <br /> the festival coordinator three(3)week poor to this event. <br /> 1 1 Name of Event: ___.�...__. ____....Dates r <br /> 2 The following is information about my organizationlbusiness: <br /> Name of organ izationibusiness <br /> t Address <br /> Phone owl �I0 ,;t-V`1g Alternate c, } � � ; �� I t� 77 <br /> 3 List food to be sold or given to the public: U !V`- '' �,1 h� f j )1 r� t.' �+�/ 4 <br /> 4. 1 am providing food that is NOT prepared at home: Yes[]No <br /> All food is prepared on-site or is from approved commercial facilities Yes❑No <br /> Name of facility Phone <br /> Address of facility <br /> 5 1 am providing a booth with the following (to protect my unpackaged food and food-preparation areas from flies, <br /> dust and the public) <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 /> Other(specify): "0 J 11 <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 /> ❑On-site hose bib that is <br /> connected to a potable water <br /> source. <br /> Other(specify): <br /> T Electricity is provided for my booth's use: ❑Yes N No <br /> 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 Ini No <br /> >am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br /> 135°F: <br /> Camp stove ❑Sterno&hotel trays <br /> Double steamer ❑Steam table&lids <br /> r,. <br /> Electric stove top ❑Other(specify) <br /> Examples of potentially hazardous food include: meats, tamales, cooked beans, rice, <br /> vegetables,potato salad,eggs,and dairy products. <br /> t <br /> _. Puna 7 nl 11 <br />