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TEMPORARY FOOD VENDOR'S APPLICATION S <br /> All food vendors (both fox profit and non-pnofit)are required to return a signed and oompkllied copy of this checklist to <br /> the festival coordinator three(3))weeks•prior to this a nt 1 <br /> 1 1,Name of Event pate(s)' Z j IDI/ <br /> 2 The foliowing is information about my o nrzatlonibuslness <br /> � 1 <br /> Name of orrgaanizationbuarness ✓V P L <br /> Address. �U <br /> Phone' (7ss/ <br /> 3 List food to be sold or given to the public- <br /> 4 1 am providing food that is NOT prepared at home Ves❑ No <br /> All food is prepared on-ante or is from approved commercial facilities /Yes ❑ No <br /> Name of fatuity Phone:(— <br /> Address of facility'_ --- <br /> 5 I am providing a troth with the following (to protect my unpackaged food and food-preparation areas from flies. <br /> dust and the public) <br /> LJ�*booth with walls anti ceiling constructed of either wood, canvas. plastic, similar material and fine mesh fty <br /> screening, completely encossng open food areas it will also have a smooth and cleanable floor (concrete. <br /> asphalt, dean tarps and smooth wood are acceptable) and oonstructed to separate food and food preparation <br /> areas from the oubiiC <br /> [-'Other(specify) —_ —_ -----. <br /> Note: The only operations not required to provide enclosed booths are those which sell beverages from <br /> approved dispensers or prepackaged foods from approved sources. <br /> 6 Approved waiter for drinking, utensil and hand washing will be provided in my boom by the following methods <br /> ❑Approved bottled water <br /> Von-site hose trb that is connected to a potable water source <br /> C other(specify) <br /> 7 Electricity is provided for my booth's use E]Yes W�No <br /> 8 i am providing an accurate probe thermometer to T"sure the hot and c6d holding of potentially hazardous <br /> foods during all times of booth operation 17 Yes V No <br /> y I am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br /> 135"17: <br /> l._J Camp stove f.� Sterno&hotel trays <br /> G' double steamer I V o� Steam table&lids <br /> L] Elednc stove top Other(specify) <br /> Note. Examples of potentially hazardous food Include: meat*, tamales, cooked beans, rice. <br /> vegetables, potato salad.agVS.and dairy products. <br /> TEMP EVENT APP <br /> E40 1"7 <br />