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TEIMpORARY FOIOD VENDOR'S APPUCAT1ONi <br /> AN fiaod ve Wcn(billh for profit and non-WM)am required to retum a sigrad avid c wViefad copy of this Ct**isit too <br /> the festival 000rclirlatcr three(3)weelm prior to#=event <br /> 1. 1.Nerve d Eventfil" - <br /> 2. The f4*wing is rdoffnia on about my Org8f1�t8Gr)n/bll <br /> Narrrn of <br /> Addresa. a t, ��3-31 <br /> Phone: Cam}) y . -7 :(6 ) 3 T -7 <br /> 3. List food to be soil or giver,to the pubilc� c �5 <br /> a. 1 am provK"food that is NOT prepared at home:' L Yes❑No <br /> AR food is prepared on-aloe or is from approved COrrlrnafdW facilities: ❑No <br /> Name of fad4tty: Phone: <br /> Address of faci ty: <br /> 5. 1 am providing a booth w rth the following: (to protect my unpodceged toad end food-pr�n areas from flies, <br /> duet and the public) <br /> kA booth with waRs and asikng cartatructed of etxher wood, canvas, plastic, svnilar material and tine mesh fty <br /> Ing, aampbtaly enclosing open food areas. it wiii also have a wmoth and cisanabie floor (cornrete, <br /> asphsR, dean tarps and smooth wood are acceptable) and constructed to separate food and food preparation <br /> areas from the public. <br /> ❑Other(Specify): <br /> Note: The any openwons not required to provide enclosed booths are those which se9 beverygea from <br /> approved dlspanaers,or prepackaged foods from approved sources. <br /> 6. Ap oved welter far drinking,utensil and hand washing wit be provided rn my booth by the foNcwwog methods <br /> Approved botried water. <br /> On-site hmm bib dud is conrK%;tW to a potable wales sou me. <br /> ❑Omer(we(--rfy).. <br /> 7. Electricity is provided for my booth's u3e06Yas❑No <br /> a. 1 am proMng an accuraile prone the to asure the hot and cold holding of potentially hazardous <br /> foods during aR times of booth operabonYes rrts 0 No <br /> 9. 1 am pmndding the fallowing hot temperature control for the hot holding of ail potentu*hazardmm floods above <br /> 135"F: <br /> T Gemp atn+ne r►a 6 hot M treys <br /> ❑Double stmoTw ffiam table 6 RAa <br /> p Elecft stove top ❑Other(specify) <br /> No": E:tmpme of poton daily hazardous food UwAuris: masts, tamales, cooked beans, rice, <br /> v@gvWb w Potato salad,apes,aM defy prodtrctas <br /> ENO t"2 TEMP EVENT APP <br /> 71=10 <br />