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i <br />of this checklist to <br />1. <br />2. <br />3. <br />4. <br />id food-preparation areas from flies, <br />5. <br />oweh (bpetsMy): <br />which sell beverages from <br />6. <br />7. <br />the hot and cold holding of potentially hazardous <br />8. <br />9. <br />meats, tamales, cooked beans, rice, <br />vegetables, potato salad, eggs, and dairy products. <br />TEMP EVENT API-Page 7 of 11EHD 16-02 <br />08/01/16 <br /> Stemo & hotel trays <br />Steam table & lids <br /> Other (specify) <br /> Camp stove <br /> Double steamer <br /> Electric stove top <br />Note: Examples of potentially hazardous food include: <br /> Other (specify):------------------------------------------------------- <br />Electricity is provided for my booth’s use: Yes S'No <br />I am providing an accurate probe thermometer to measure <br />foods during all times of booth operation: Yes No <br />I am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br />135°F: <br />TEMPORARY FOOD VENDOR’S APPLICATION <br />tectum a signed and coveted cop, <br />------Da,e(s’ <br />ionTousiness: <br />' " F --------- <br />) <br />I.Name of Event:. <br />The following is information about my organization.— <br />Name of organization/business: G U 5 <br /> Address: <br /> <br /> <br /> <br /> Name of facility: ----1 <4- ffVVSV <br />Addre^ of <br />I am providing a booth with the following: (to protect my unpackaged food an <br />dust and the public) aterial and fine mesh fly <br />□ A booth with walls and celling constructed ot either wood canvas. "Ste floor <o°"or«,en <br />S ^aSb^X^cted to separate food and food preparation <br />areas from the public. - <br /> Tnod ~Tn.i de J------------------- <br />Noto: The only operations^oWequtfed-tb^vide enclosed booths are those <br />approved otapensers, 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 />^Approved bottled water. <br /> On-site hose bib that is connected to a potable water source.