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�'h t11� Vhcese �.r,dwtc�� <br /> TEMPORARY FOOD VENDOR'S APPLICATION <br /> All food verxiors(both for profit and wo-mm)are required to return a signed and corniplabed copy d this diiecklmd to <br /> the festival oDorrfinatflr threel(3)weeks prior to this event. � Ok <br /> �4 te(3) / <br /> 1 1.Name of Event' ! �� r � i pa <br /> 2 The following n wdormation about my organizatronlbuswiess: <br /> Narne of orgsnizafioNbusiness: <br /> 26�,:;:7Z'8 n� - <br /> Address: �} <br /> Phone: Sr o r)��.c�L — Alternate: <br /> 3 List food to be sold or given to the public. <br /> 4, l am providing food Chet is NOT prepared at homeX yes❑No <br /> All food is preparedr94-8' <br /> or is from oved faciEities Yes+..❑No ��� <br /> Name of fatality' r i e� i o d Phone: <br /> Addrm of fealny: ti ✓•-� T/:i ✓� / . <br /> 5 1 am providing a booth with the tollowing• (to protect my unpackagad food and food-reparation areas from flies. <br /> dust and the public) <br /> booth with wells and ceiling constructed of either wood, canvas,plastic, similar malarial and fine mesh Ry <br /> screening, completely enclosing open food areas. it will also nave a smoother <br /> and tlerabb floor (concrete. <br /> asphalt, d od clean tarps and smooth wo are acceptable) and oonstructed to separate flood and food preparstion <br /> areas from the public. <br /> C Other(specify): <br /> NOW. The only operations not required to provide enclosed booths am those which sell beverages from <br /> approved dispensers,or prepackaged foods from approved sources. <br /> 6 Approved water for dnnking,utensil and hand washing will be provided in my booth t7y the following methods <br /> /KApproved bottled wader <br /> ❑On4te hose bob that is connected to a potable water source. <br /> C Other(specify) <br /> 7 Eibctricity is provided for my booth's use:;KYes 0 NO <br /> a- I am providing an accsirste probe thermometer to measure the hot and cold holding of potentiality hazardous <br /> foods during all times of booth operation. Yes❑ No <br /> g 1 am providing the following hot temperature control for the hot holding of all potentially taazardous foods above <br /> 135T: <br /> ©camp stove []stamp&hotel trays <br /> gDoubie steamer ❑Steam teble&Rds <br /> ❑Electric stove top ❑Other(ly) <br /> NOW: £xampNs of pokstlWlgy hatazardoue food Inclixis: meats, tamales, cooked beam, rice, <br /> vegetablem potaw salad,agigs,and dairy products. <br /> TEMP EVENT APP <br /> EV40 1"2 <br /> rrzarro <br />