Laserfiche WebLink
TEMPORARY FOOD VOKUPOR"" AFPUC.T N <br /> M faad vw,60 s (gain kir profit and nw-wft)arc reqult�•to return a sx-y!'ad Wei corlvietw copy Of t" rnec,V.l�t to <br /> the festival coordinator three(3)weeks pricer to tnis ev' lz <br /> 1 1 Nary,of Event. .—_� <br /> The fofkwong 15 inforrm at+ori about my organization/business: <br /> en,rV <br /> Name of of aaticuti�usirxsss: <br /> ga <br /> _-- <br /> �� <br /> Phone: Wtesnata: { �) ��2/�✓]�c ) <br /> � -�____.—��_ µC� � <br /> List food to be sold or.giveqj to the pubitc. <br /> 4. f am providing food that is NOT prepar-+kl at horne:XYes❑ No <br /> All food is prepared on-site or is from approved commercial fac:iiitsf s:' Yes [i No <br /> r- Phl o te:�. l <br /> Marne at facility 'Irk �'"(}p�- -�C <br /> - - - � -- <br /> Address of facil' <br /> 5. l am providing a booth with the fallowing: (to protect my unpacicaged fr)od and food-preparabon areas from flies <br /> dust and the public) <br /> 0 A booth with wallet and ceiling constructed of afther wood, canvas, plastic, similar material and fine mesh fly <br /> scraening, completely e►nckWng open food areas, it will also have a smooth and tie anabfe floor (concrete, <br /> aspftatt, clean tarps and smooth wood are acceptable) and constructed to separate food and food preparation <br /> areas from the pubfic. <br /> %Other(sPecitY): �.._.�- ---� <br /> Note: The only operations not required to provide ancloSc t�aoths are those which seat beverage From <br /> approved dispensers, or prepackaged foods from approved sources. <br /> 6- Approved wator for drinking, utensil and hand washing will be provided in my Moth by the foHawing methods. <br /> 70%wroved battled water. <br /> On-site tease bib that is unnnected to a potable*?i(,, sofime <br /> Other;sperc6j) <br /> 7 Electricity is provided for my booth's use �.Yes F i No <br /> 8 f am providing an a.:.c:urate probe thermometer to measure the hot and nold h0dir-kg of poterrttoHy hazardous <br /> (cads during all times of booth operation:K Yes[-3 No <br /> 9 i am providing the following hot ternpefature control for the not noldlnq of all potentially hazardous foods above <br /> 135`•F' <br /> Camp stove L-1 ,3temo&hotel trays <br /> Double sibamer -{ beam tabka& lids <br /> lectric stove top ]ether{specify) <br /> Nate; Ex.arnptel� of pot-rwtudly haz_ardjura food lrchide. njeaLS, tZait+&itav�, ccst)K&d 4*ami, rice; <br /> vegeiabtes, potato salad. ogp%, and hairy products. <br /> TEIUIP EVENT APR <br /> EH0 1 B-az2 <br /> 7-WiO <br />