Laserfiche WebLink
TEMPORARY FOOD VENDOR’S APPLICATION <br />Date(s) May 25 & 26, 2016Cajun & Blues FestivalI.Name of Event:1. <br />The following is information about my organization/business2. <br />Address: <br />Phone ( 707 > 987 2158- <br />List food to be sold or given to the public3. <br />4. <br />5. <br /> Other (specify). <br />Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods6. <br /> Approved bottled water <br />Electricity is provided for my booth s use: Yes Q No7. <br />8. <br />9. <br />TEMP EVENT APPPage of 11 <br />£ <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 />On-site hose bib that is connected to a potable water source <br /> Other (specify):_______ <br /> Camp stove <br />Q Double steamer <br /> Electric stove top <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: iX Yes No <br />35 Sterno & hotel trays <br /> Steam table & lids <br />FYOther (specify; GRILL <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 />EHD 16-02 <br />7/14/16 <br />Name of organization/business: Cajun Queen <br />POB 1693 Middletown, CA 95461 <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 /> Alternate ) 51q) 4109146 ....---------- - ----- <br />Crab Cakes, Jambalaya, French Fries, Beignets, Alligator <br />I am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br />135T <br />pt] 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 />Note: Examples of potentially hazardous food include: <br />vegetables, potato salad, eggs, and dairy products. <br />meats, tamales, cooked beans, rice, <br />I am providing food that is NOT prepared at home. Yes O No <br />All food is prepared on-site or is from approved commercial facilities: Q^Yes [—] No <br />Name of facility F2 Family Winery ... Phone ( 209 334-5.9.1.1. <br />Address of facility:_ 9009 Hwy 12 Lodi