Laserfiche WebLink
TEMPORARY FOOD VENDOR’S APPLICATION <br />t Name of Event:1. <br />2 <br />Address <br />Phone: <br />3. <br />4. <br />5. <br />Approved water for drinking, utensil and hand washing will de provided in my hootn by the following methods:6. <br /> Approved bottled water <br />Electricity is provided for my booth’s use: Yes KI No7. <br />8 <br />9. <br />meats, tetmales, cooked beans, rice. <br />Page 7 ofii <br />TEMP EVENT APT <br />O Camp stove <br /> Double steamer <br />O Elecb ic stove top <br />I am Pfovtaing an accurate probe thermometer to m <br />foods during all times cf booth operation: Q Yes ® <br /> Stemo & hotel bays <br />Q Steam table & lids <br />0 Other (specify) <br />No«e: Examples of potential y hasartious food include- <br />vegcteblas, potato salad, eggs, and dauy products. <br />I am providing a booth with the following: (toprotect my unpackaged food and fbod-pieparabon areas horn flies, <br />dust and the public) <br />Oate($); <br />EHO 16-32 <br />wo me <br /> On-ste hose bib that is connected toa potable water source. <br />(3 Other (specify}: ____________________ <br />All food vendors (both for profit and non-profit) are required to return a signed and completed copy of this checkl^t to <br />the festival coordinator- three (3) weehs prior to this event. <br />Weberstown Farmers Market <br />The following is information about my organiaettorVbuSiness' <br />Name of oigantzation/business; 'IoKa <br />Note: The only operations not required to provide enclosed booths are those which sell beverages from <br />approved dispenses, or prepackaged foods from approved sources. <br />N^V/^6 hOt an<1 hO,dirb5 Of pctentid|y ba*srdous <br />I an providing the fallowhg hot temperature control for the hot holding of all potenttelfy h fcardous foods above <br />J I - <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 deanabte floor (concrete <br />asphali; dean tarps and smooth wood are acceptable) and constricted to separate food and food preparation <br />areas from ttie public. <br />El Other (specify): AW dUA a <br /> CA 3g>oi|_____ <br />Alternate: ( )__________ <br />List food to be sold orgiren to thepwlia <br />I am providing food that is NOT prepared at home: 0 Yes No <br />All food is prepared on-site or is from approved commercial facilities; [2 Yes No <br />Name of facility TA A JF xV ( < S ____Phorw: (2f)) --------- <br />Address nf facility voO Ixtfo n