Laserfiche WebLink
1. <br />2. <br />Phone: <br />3. <br />4. <br />5. <br />EJ Other (specify): <br />Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods:6. <br /> Approved bottled water. <br />7. <br />8. <br />9. <br />meats, tamales, cooked beans, rice, <br />Page 7 of 11EHD 16-02 <br />oj-ovie <br />jS Camp stove <br />D Double steamer <br /> Electric stove top <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 /> Stern o & hotel trays <br /> Steam table & lids <br /> Other (specify) <br />about my organlzation/businnss <br />List food to be sold or given to the public:' <br />Note: Examples of potentially hazardous food include: <br />vegetables, potato salad, eggs, and dairy products. <br />I am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br />135°F: <br />I am providing food that is NOT prepared at home: Yes EH 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: /T <br />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 />QE 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 />, /e Si. h'YYZMLL ^26 <br />__________ Me.rpw <br />TatudljiJ /('&.“ (ie.________ <br />yH Other (specify): r- I <br />Electricity is provided for my booth’s use: Yes^ No <br />I 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 />TEMPORARY FOOD VENDOR'S APPLICATION <br />thp f°r Pr°f|’ and non-profit) are required to return a signed and completed copy of this checklist tome festival coord.nator three (3) weeks poor to this event. Q1 ,n . uc <br />ouncjays <br />1. Name of Event; Weberstown Farmers Market Date(s): Year Round <br />The following is information <br />Name of organization/business: <br />Address: / -//->/ <br />Q On-site hose bib that is connected to a potable water soume. / / /4/-