Laserfiche WebLink
TEMPORARY FOOD VENDOR’S APPLICATION <br />1.I .Name of Event: <br />2. <br />Address. <br />Phone: <br />3.List food to be sold or given to the public: <br />4. <br />5. <br /> Other (specify): <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 />Electricity is provided for my booth's use:7. <br />8. <br />9. <br />meats, tamales, cooked beans, rice, <br />Page 7 of 11 TEMP EVENT APPEHD 16-02 <br />7/14/15 <br />Note: Examples of potentially hazardous food include: <br />vegetables, potato salad, eggs, and dairy products. <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 />I am providing a booth with the following: (to protect my unpackaged food and food-preparation areas from flies, <br />dust and the public) <br /> Sterno & hotel trays <br />® Steam table & lids <br /> Other (specify) <br /> Camp stove <br /> Double steamer <br /> Electric stove top <br />I am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br />135°F: <br />l. Date(s): <br />[ZrA 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 />es No <br />I am providing an accurate probe thermometer to measure the hot and cold holding of potentially hazardous <br />foods during all times of booth operation:'0Ves No <br />I 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 No <br />Name of facility: [A < )Phone: (T/4> ) 3?( 2- <br />Address of facility:______________________ <br />All food vendors (both for profit and non-profit) are required to return a signed and completed copy of this checklist to <br />the festival coordinator three (3) weeks prior to this event. <br />ctw/y V/? <br />The following is information about my organization/business: <br />Name of organization/business: C ,'.X , <br /> Alternate: ( 2/?^) (3 9- 5