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Rec-001-B <br />TEMPORARY FOOD VENDOR’S APPLICATION <br />1. <br />2. <br />3. <br />4. <br /> Other (specify): <br />5. <br /> On-site hose bib that is connected to a potable water source. <br /> Other (specify): <br />Electricity is provided for my booth's use-JZTVes No6. <br />7. <br />8. <br />meats, tamales, cooked beans, rice, <br />EHD 16-02 TEMP EVENTAPP <br /> Camp stove <br />J3 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 />Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods; <br />-rETApproved bottled water. <br />Date: <br />12/1/23 <br />‘JZf^terno & hotel trays <br />Steam table & lids <br /> Other (specify) <br />Note: Examples of potentially hazardous food Include: <br />vegetables, potato salad, eggs, and dairy products. <br />Page 7 of 11 <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 />I am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br />135°F: <br />Name of org^njzation/business: teA'/z,/vj 5^°^ <br />List food tojre sold or given to the public: <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: 0 Yes No <br />The following is information about my organization/business: <br />I C?. C ACA "-! <br />Alternate: <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: ,0'Ves No q <br />? ph°ne: <br />lam providing a booth with the following: (to protect my unpackaged food and food-preparation areas from flies, <br />dust and the public) <br />^ETAbooth with walls and ceiling constructed of either wood, canvas, plastic, similar material and fine mesh fly <br />screening, completely enclosing open food areas. II 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.