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TEMPORARY FOOD VENDOR’S APPLICATION Datefs):1.r. Name of Event: 2. Address: Phone: 3. 5. 6. 7. I am providinfl an accurate probe thermometer to8. B. 135°F: meats, tamales, cooked beans, dee, Page 7 of 11 ■ 4.^ D Camp stove Double steamer O Electric stove top TEMP EVENT APP List food to be sold or given to the public: ■ ■ All food vendors (both for profit and non-profit) are required to return a signed and completed copy of this checklist to the festival coordinator three (3) weeks prior to this event. Weberstown Farmers Market Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods: O Approved bottled water. On-site hose bib that is connected to a potable water source. Other (specify); ______ Electricity is provided for my booth's use: Q Yes (hTno I am providinfl an accurate probe thermometer to measure the hot and cold holding of potentially hazardous foods during all times of booth operation: D Yes Mno ... . • ‘ . y. < . ' ' • I am providins the following hot temperature control for the hot holding of all potentially hazardous foods above Sundays Apr-Apr . -■ Stemo & hotel trays O Steam table & lids Other (specify) Note: Examples of potentially hazardous food include: vegetables, potato sated, eggs, and dairy products. Ml ‘ A •’1 i ? - r:.< •' ■f- • .> . 1 All food is prepared < Name of facility: _j Address of facility:________________________.. . •. y ——7T- • y; I am providing a booth with the following: (to protect my unpackaged food and food-preparation areas from flies, dust and the public) ' \ / ' ' '_■/ .I,-".'. ■ A booth with walls and ceiling constructed of either wood, canvas, plastic, simitar material and fine mesh fly screening, completely enclosing open food areas. It will also have a smooth and cleanabte floor (concrete, asphalt, cteai tarps and smooth wood are acceptable) and constructed to separate food and food preparation areas from the public. O Other (specify):_ _______________________ _ Noto: The only operations not required to provide enclosed booths are those which sell beverages from approved dispensers, or prepackaged foods from approved sources. EHb IB-02 0B/0V16 f The following is information about my organization/business: Name of organization/business: RMlit f.o(n S-l.ll Dr fa, <4aT -L« zrr ---------------------- Alternate!^ ) 13. I am providing food that is NOT prepared at home: ^Yes O No site or is frorrl approved commercial facilities: [^Yes Q No tKS w JAvytWj laew j-— ■Sts! y.