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TEMPORARY FOOD VENDOR'S APPUCATION <br /> Ail food verteie,rs(haffi for fpium artd non-pfuth%are requited IC, r,:�tcirn a sgned and conV**d copy of tins Oeckifs*• !o <br /> qfa;festival coorr3inato:three(3)weeks prupr to this event <br /> I Narne O i=verii ��+fL'�--�'tL -���t�� 6 c�o���6/7zal8 <br /> Ttie fallowing es information about my organtzatton,'ou5sness <br /> Nartva of ofganizatiotubi Wr'dss I -- - - <br /> ALkh <br /> Pnone (&Io 1 9� Q--- - — PJternate.t 510 3D� �3 <br /> �'1,IA1io7Vt�3 <br /> 3 Ltsi frxxi to be sold or given to the publ;e. -_--- -- -- --_ ----- <br /> A I am providing food that is NOT prepared at home. Yes U No <br /> Al;t,x'xJ is prepared on-site or is frwi approved c..orivnerciat faritit,es 7-11 Yes Pt <br /> Name of fat'llity - <br /> Addless of faGirty -_ -- - — _----------- - -- - -_. ---- -- <br /> I am providing a rK)oth with the following (to project my unpackaged ford and food-preparaflon areas from Ares <br /> ctList and the public) <br /> LA,A booth with walls and ceiling constructed of elttter wood, canvas, plastic simil;at material ano fine Masi) fly <br /> sareening, cornplately enclosing open food areas it will also gave a smooth and ceanaWe floor fconcretc, <br /> asphalt. ejean tarps and smooth wood are ameptable) and cpnstructed to separate food and food preparation <br /> areas from tne,oubl e. <br /> 01ther (sfpet:dy) - _.... -- --�_ - --- -- -- <br /> Note. t he only operalions rl(H required to provide anciowd booths are )hose whicP seir tWverWJea t,0111 <br /> approved dispensers,or prepackaaged foods from approved sources. <br /> AL>prove34d wafer for drinking,utensil and hand washsrig will ba provided in my booth by the fatkpwing metrtods <br /> �*Atppwved buttlW water <br /> U on-sine rjut�e bib treat is connecled tc,a potable water sciurct- <br /> Other f.spec4) <br /> Elec,uic ity is proviided for my txxxti s u +e9 Yes L-_Na (oF.,v�QR'�'Z Ni ,�r S��rx ©U/� <br /> r ant providing an acxourate prone theFTrIGMeter to measure" tna hol anvi cued holding or potentially haxardr,ein <br /> tars during all times Of txpath overalion ;M Yes F1 No <br /> t an) providing the fallowing hot tgrnperature control for the hot noldmg or all i>otentfally hazardous kxAs above <br /> .35`t <br /> i:arnp sFov� l 1 Siefiw& hotel trAYS <br /> L_C3ouUks sir3aritry+ r-,Stntarn table R lids 4/k Fp (/s <br /> 6'k;l;iftc stova top L Other(saecrfyi <br /> Note. Examples of poterntially nazardotte tood include: inuats' t:tnraiur;, cookbrl beans, rice, <br /> vegetatplrrs, potato naiad,aggs,arid dairy products. <br />