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lv\^ <br />TEMPORARY FOOD VENDOR’S APPLICATION <br />All food vendors (both for profit and non-profit) <br />2. <br />Phone: <br />3. <br />4. <br />5. <br />6. <br />7. <br />8.the hot and cold holding of potentially hazardous <br />9.above <br />Rage 7 of 11 TEMP EVENT ARP <br />EHD 16-02 <br />7/14/15 <br />qJJ] Sterno & hotel trays <br /> Steam table & lids <br /> Other (specify) <br />Note: Examples of potentially hazardous food include: <br />vegetables, potato salad, eggs, and dairy products. <br />are those which sell beverages from <br />. .. , • . ) are required to return a signed and completed copy of this checklist to <br />the festival coordinator three (3) weeks prior to this event. 4/il- 22- J 5/fc <br />1. 1. Name of Event: Nttgevl <br />1 ^s^and th9 3 ^1°^ follow'n9: ^to protect my unpackaged food and food-preparation areas from flies, <br />^\|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 />areasafrom3ahetpubBcand Sm°Oth W0°d are accePtable) and constructed to separate food and food preparation <br /> Other (specify): <br />meats, tamales, cooked beans, rice, <br />Electricity is provided for my booth’s use^JQ Yes No <br />I am providing an accurate probe thermometer to measure <br />foods during all times of booth operation: Yes No <br />1 a^ Poroviding the following hot temperature control for the hot holding of all potentially hazardous foods <br />135 F: <br /> Camp stove <br /> Double steamer <br /> Electric stove top <br />Note: The only operations not required to provide enclosed booths <br />approved dispensers, or prepackaged foods from approved sources. <br />Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods: <br />(^L^pproved bottled water. <br /> On-site hose bib that is connected to a potable water source. <br /> Other (specify): <br />The following is information about my organization/business: <br />Name of organization/business: <br />Address: -1-1 | ^533^. <br />(?? fyllfC Alternate: ('2^/ )_ ^)^(23"7$ <br />List food to be sold or given to the public: ; W > <br />I am providing food that is NOT prepared at home: 0 Yes No <br />All food is prepared on-site or is from approved commercial facilities^ Yes No <br />Name of facility: ________________________________Phone: ( }_____ <br />Mdress of facility:__