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SAN > Environmental stealth Department -- our >v_ TEMPORARY FOOD VENDOR'S APPLICATION All fond vendors(both for profiit and non-profit)are required to return a signed and completed cOPY of this checklist to the festival coordlnatar three(3)weeks prior to this event_ - €_ 1.Name of Event Date(s) 2. The Mowing is information about my organizationlbusiness: dame of oraganiza5or>ibusiness: I��i 5b-. -�rsL -�-.� r• -1,� Adds s: 2kS Phone: -2 5 Alternate-( ) 3- List food to be sold or given to the public: '' C'- i 4. l am providing food that is NOT prepared at home_ n No All food is prepared once or is from approved commercial fairs-- 'Yes F1 No Name offacky_ �� ' ., - � Phone: Address offa� --^J-10 In! 5 t � 5_ t am providing a booth with the following-(to protect my unpadcaged food and food-preparation areas from flies, r dust and the public) Q A booth inurllt walls and ceiitrg r orrsirrlcieded of a wood,canvas, plash,s►riiifar mafeitai and erne mesh fly screening, cornpletely enclosing open food areas- it will also have a smooth and cleanable floor(concrete, asphalt clean tarps and smooth wood are acceptable)and constructed to separate food and food preparation areas from the public. ❑Other(spay)= a Note: The only operations not required to provide enclosed booths are those which sell beverages from approved dspensers,or prepackaged foods fawn approved sources- 6. Approved water for drinking,utensil and hand washing will be provided in my booth by the following methods: ❑Approved bottled water_ ❑On-sate hose bib that is connected to a potable water source. ❑Other(specify)= 7. Electricity's provided for my booth's use:❑Yes Q No 8. l am providing an accurate probe thermometer to measure the hot and cold holding of potentially hazardous foods during all tirrres of booth operation:El Yes Q No 9. i am providing the following hot temperature control for the hot holding of all poWn ialiy hazardous foods above 135 F: ❑Camp stove ❑Sterno&hotel trays ❑Double steamer ❑Steam table&lids 0 Electric stove top ❑Other(spe(tify)