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TEMPORARY FOOD VENDOR’S APPLICATION <br />April 2, 20251 <br />2. <br />GAAddress. <br />Phone- <br />3 <br />4. <br />5 <br /> Other (specify)- <br />6 <br /> On-site hose bib that is connected to a potable water source <br /> Other (specify): <br />7 <br />8 <br />9 <br />meats, tamales, cooked beans, rice, <br />TEMP EVENT APPPage 7 of 11EHD 16-02 <br />08/01/16 <br />Camp stove <br /> Double steamer <br /> Electric stove top <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 />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 /> Stemo & hotel trays <br /> Steam table & lids <br />O Other (specify) <br />Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods <br />Approved bottled water <br />Electricity is provided for my booth’s use Yes H^No <br />Gf 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 />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 />All food vendors (both for profit and non-profit) are required to return a signed and completed copy of this checklist to <br />the festival coordinator three (3) weeks prior to this event <br />1 Name of Event’ R tv,GARMfeR's <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 EZfVes No <br />The following is information about my organization/busmess <br />Name of organization/business’ <br />ms TRAG^ <br />( ^ 7 S ) Sff - S Alternate ( ) <br />List food to be sold or given to the public: <nCL GfiVM GMK'i' j.CPRTkKT) Qfttt <br />I am providing food that is NOT prepared at home: Yes No <br />All food is prepared on-site or is from approved commercial facilities. (x/fYes O No <br />Name of facility Phone. ( .) <br />Address of facility.__________________ _______________________________