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TEMPORARY FOOD VENDOR’S APPLICATION <br />1 Nameof Event <br />2 <br />Address r <br />Phone <br />3 <br />4 <br />-C- <br />5 <br />Gk/c/C • <br />6 Approved water for drinking, utensil and hand wasting will be provided in my booth by the following methods <br />O Approved battled water <br />QOn-s>le hose bbthat 6 connected to a potable water source <br />7 <br />8 <br />§ <br />meats, tamales, cooked beans, rice, <br />FJ9C 7 Of 11 TEMP EVENT aj»p <br /> Camp stove <br /> Double steamer <br /> Eiednc stove top <br />1 am providing a booth with the following (to protect my vnpackaged food and food-pre pa ration areas from fl'es. <br />dust and the public) <br />0 Sterno & hotel trays <br />O Steam tables lids <br /> Other (specify) <br />21U <br />______ <br />ngned and completed copy of this QiecMSt to <br /> Date(s) Thursdays MaiToctp <br />O A oooth with walis and veiling constructed of either wood canvas plastic, similar material and fine mesh fly <br />screen ng. completely enclosing open food areas It will also have a smooth and cleanable Itoor (concrete, <br />asphalt dean tarps and smooth wood are acceptable) and constructed to separate food and food preparation <br />areas from the public <br />JS^OOier (specify) <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 />eno 16<I2 <br />wi>im <br />D Other (specify) ________________ <br />Electricity «s provided for my booth s use Q Yes pt^No <br />I am providing an accurate probe thermometer 10 measure the hot and cold holding of potentially hazardous <br />foods during all times of booth operation 0 Yes C^No <br />I am provdrng the following hot temperature control for the hot holding of ail potentially hazardous foods above <br />13ST G <br />____ __ j ^'es no <br />prepared on-site or s from approved commercial facilties WYes Q No <br />‘ ° ' - Phoned ^11Rosa's <br />0 LT 1_ <br />Note: Examples of potentially hazardous food include: <br />vegetables, potato salad, eggs, and dairy products. <br />All food vendors (both for profit and non-profit) are required to return a si <br />the festival coordinator three (3) weeks priorto this event <br />Market on Maple <br />The (blowing is information about my orgamzaton/business <br />Name of organizatonfausmess ft ----------- -------------- <br /> <br /> <br />1st food to be sold org>ven to the public <br />I am providing food that is NOT prepared al home <br />Al food >s | <br />Name of facility J <br />Addressoffacility