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* <br />t <br />TEMPORARY FOOD VENDOR’S APPLICATION <br />MOUNTAIN HOUSE FARMERS MARKET1.I Name of Event <br />2 <br />Address: <br />Phone <br />3. <br />4. <br />5. <br /> Other (specify) <br />Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods:6, <br />^3 Approved bottled water. <br /> On-site hose bib that is connected to a potable water source <br /> Other (specify) <br />7 <br />8 <br />9. <br />TFMP FVFNT APPPage 7 ol 11EHD 16-02 <br />08/01/16 <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 />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 /> Camp stove <br /> Double steamer <br /> Electric stove top <br /> Stcrno & hotel trays • <br />S^reao^ablo & lids <br /> OlhorTsp.ccTTy< <br />Date(s) YEAR <br />ROUND <br />'EA booth with walls and coiling constructed of either wood, canvas, plastic, similar material and fine mosh fly <br />screening, completely enclosing open food areas. It will also have a smooth and clcanable 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 />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 />Electricity is provided for my booth's use: YesSj^No <br />I am providing an accurate probe thcrmomojgr to measure the hot and cold holding of potentially hazardous <br />foods during all times of booth operationij^^fe-. EJ No <br />T he following is information about my organization/business <br />Name of organization/business: Hain <br />i&-\ cvwytpeaT^ve MlfedeSTbjCrr ^35^ <br /> Alternate ( ) <br />List food to be sold or given to the public: <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-^ Yes No <br />Name of facility:Phono £ <br />Address of facility <br />meats, tamales, cooked beans, rice, <br />I am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br />I3TT\ ..