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TEMPORARY FOOD VENDOR'S APPLICATION <br /> All food vendors (both for profit and non-prollt)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. 1.Name of Event, Kite Festival, July 4, Aug MIP, Sept MIP . Date(s) 6-1,7-4,8-17,9-24 <br /> 2. The following Is Information about my organizationlbuslness; <br /> Name of organlzationlbuslness; �c�i.s�Sc! ��d �• <br /> Address; W , <br /> { '¢ '7G -G j 6s 05t ' �0 -7ls' <br /> Phone; _ Alternate; ( )_ G 6 7Gf 1.3 <br /> 3• List food to be sold or given to the public; <br /> 4. 1 am providing food that is NOT prepared at home; Yes❑ No <br /> All food Is prepared on-slte or Is from approved commerolal facilities: P 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 files, <br /> dust and the public) <br /> I] 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 Wooth and oleatleble 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); <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 /> i <br /> ❑Approved bottled water. <br /> ❑On-slte hose bib that Is connectedfor a potable water source, j <br /> ® Other(specify); 5 rl 4 c,,t�t ti! r 1 4t 5 <br /> uJr�.yLd <br /> 7. Eleotrlolty 1s provided for my booth's use; ®Yes ❑ No <br /> •r�y7 ' uJ�ll f���VI6 1 U4i,� C�,,lk r. �1.c.•1r. <br /> B. 1 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 N <br /> 9, 1 am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br /> 1360F: <br /> ❑Camp stove ❑ Sterno& hotel trays <br /> ❑ Double steamer ❑Steam table&lids <br /> ❑ Electric stove top ❑Other(specify) <br /> Note: Examples of potentially hazardous food Include, meats, tamales, 000kod beans, rice, <br /> vegetables,potato salad, eggs,and dalry products, <br /> CHP WQ? Page 7 of S1 TEMP EVENT APP <br /> WOMB <br />