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l.Name of Event: <br />2. <br />Address: <br />Phone: <br />3. <br />4, <br />5. <br />6. <br />7. <br />8. <br />9.I am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br />135'F: <br />meats, tamales, cooked beans, rice, <br />Pago 7 ofll Tf MP FVFNT APP <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: Yes <br />0Camp stove <br /> Double steamer <br /> Electric stove top <br />Note: The only operations not required to provide enclosed booths <br />approved dispensers, or prepackaged foods from approved sources <br />Appioved water lor drinking, utensil and hand washing will bo provided in my booth by the following methods: <br />B^pproved bottled water. <br />Date(s): YEAR <br />ROUND <br />FHI) 16 0? <br />08/01/16 <br />are those which sell beverages from <br />TEMPORARY FOOD VENDOR’S APPLICATION <br />»"sassKissixs,™ sr “ “m • ....« -»”»“»»» <br />I ■ 1 • Name of Event: MOUNTAIN HOUSE FARMERS MARKET <br />The following is information about my organization/business: <br />Name of organization/business: fo&Xub <br />toco CWvch AM A <br />(^i Alternate: ( ) <br />List food to be sold or given to the public: <br />I am providing food that is NOT prepared at home: B'yos No <br />All food is prepared on-site or is from appr^v^commercial facilities' <br />Name of facility: OVA | \ <br />Address of facility: <br /> Sterno & hotel trays <br /> Steam table & lids . <br />QOther (specify) <br />Note: Examples of potentially hazardous food include: <br />vegetables, potato salad, eggs, and dairy products. <br />booth with walls and ceiling 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 clcanablo floor (concrete, <br />areas frorn^the pTf Sm00lh woocl aro acceptable) and constructed to separate food and food preparation <br /> Other (specify):_________ <br />I am providing an accurate probe theimometerjo measure the hot and cold holding of potentially hazardous <br />foods during all times of booth operation: Bros No <br />I am providing food that is NOT prepared at homo. <br />All food is prepared on-site or is from B^Yos No <br />1 ^dusTand the public? following: (to protGct m'>/ wnpackaged food and food-preparation areas from flics.