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TEMPORARY FOOD VENDOR'S APPLICATION <br /> All food vendors(;Stith for profit and non--profit) are required to return a signed and completed copy of this checlftt to <br /> the festival coordinator three(3)weeks prior to this event /� L 1. 1.Name of Event l— /"l 1t r � <br /> 2. The following is information about myyoor-ganization/bbu—siness:/ <br /> Name of organization/business:. /G cD <br /> Address: / eL cjge ✓e d <br /> Phone: U-09 ). 5 a5 16 ZQ _ Alternate: <br /> 3. List food to be sold or given to the public: Cr his QPT / 4S Lc/4lZor <br /> 4. 1 am providing food that is NOT prepared at home: Yes❑No <br /> All food is prepared on-site or is from approved commercial facilities:,®Yes 0 No <br /> Name of facility: 2L46�a „t cc- le, t Phone: <br /> Address of facility, J�LT r r kAra L✓C 1� �,[< [' _..f:5 36 J <br /> 5. 1 am providing a booth wrth the following;(to protect my unpaekaged food and food-preparation areas from flies, <br /> dust and the public) <br /> JQ A booth with walls and ceiling constructed of either wood, canvas, plastic,similar material and fine mesh fly <br /> screening, completely enclosing open food areas. It will also have a smooth and cleanable floor (concrete. <br /> asphalt,clean 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 orgy operations not required to provide enclosed booths are [hose which sell Beverages f[cm <br /> approved dispensers,or prepackaged foods from approved sources. <br /> 6. Approved water for drinking,utensil and hand washing will be provided In my booth by the following methods: <br /> Approved bottled water. <br /> ❑On-site hose bib that is connected to a potable water source. <br /> ❑Other(specify): <br /> 7. Electricity is provided for my booth's use:R]Yes❑ No <br /> t3. I am providing an accurate probe thermometer to measure the hot and cold holding of potentially hazardous <br /> foods during al[times of booth operation:P9 Yes❑No <br /> 9- t am providing the following hat temperature control for the hot holding of all potentially hazardous foods above <br /> 135"F: <br /> a camp stove ❑Stemo&hotel frays <br /> UDouble steamer ❑Sleam table&lids <br /> ❑Elecl6c stove top ❑Other(specify) <br /> Note: Examples of potentially hazardous food include: meats, tamales, cooked beans, rice, <br /> vegetables, potato salad,eggs,and dairy products. <br /> EHD 1"2 Page 7 01 11 <br /> 7129l10 TEMP EVENT APP <br />