Laserfiche WebLink
TEMPORARY FOOD VENDOR’S APPLICATION <br />1-Name of Event: 1. <br />2. <br />Address: <br />Alternate: (Phone: <br />3 List food :s be sold or given to ths public; <br />4 <br />Ce/rWaA -KidizsftS <br />5 <br /> Other (specify): <br />6. <br />NoElectricity is provided for my booth's use:1 <br />8. <br />9. <br />meats, tamales, cooked beans, rice, <br />TEMP CVuN f A'JPPage 7 of 11SHD 16 02 <br />n/4/14 <br />Camp stove <br />Double steamer <br />lectric stove top <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 />I am providing the following hot temperature controi for the hot holding of all potentially hazardous foods above <br />135’F: <br />Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods: <br />^Approved bottled water. <br />f^pn-sile hose bib that is connected to a potable water source. <br />i'I Other (specify)' <br /> Sterno & hotel trays <br />^^Steam tab e & lids <br /> Otner (speciby) <br />TCA booth with wails and celling constructed of eithei wood, canvas, piastic. similar inatenai and fins mesh fly <br />screening, completely enclosing open food areas. II wfl 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 />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 />I am providing food that is NOT prepared at home. Av'es No <br />Al! food is preparedlor -site or is from approved commercial facilities: No <br />Name of facility. CeM-rfei -Kstklwas______ptwne 2^ '3>3cl-8£>Z<?. <br />Address of fasliry:. 2SQ S. &u.U Avt. Su:4t A. <br />I am providing an accurate probe thermometer to measure the hot and cold holding of potentially hazardous <br />foocs during all times of booth operation: V v'es (. j No <br />Daie(3) <br />hCo/ja <br />The foltowing is information about my organization/business: <br />Name of organization-business: JJobb*t Flare.