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2. <br />Address: <br />3. <br />4. <br />1 <br />5. <br /> Other (specify): <br />6. <br /> Other (specify): <br />7. <br />8. <br />holding of potentially hazardous <br />9. <br />food include:meats, <br />Pa9e7of n <br />temp event app <br />EHD 16-02 <br />08/01/16 <br />Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods: <br />Xl Approved bottled water. <br /> On-site hose bib that is connected to a potable water source. <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 />1. Name of Event: - -------- -— ' <br />The following is information about my organization/business: <br />Or <br />of this checklist to <br />Thursdays <br />May-Oct <br />TEMPORARY FOOD VENDOR’S APPLICATION <br />vendors (both for profit and non-profit) are required to return a signed and completAll food vendors (both for profit and non-profit) are r <br />the festival coordinator three (3) weeks prior to this event. <br />1 • Marketon Mapje___Date(s): <br />areas from flies, <br />Name of organization/business: <br />I Ll4 Cdir-u. <br />Phone: (^ 5L <br /> <br />List food to be sold or given to the public:^ <br />I am providing food that is NOT prepared at home: Yes No <br />All food is prepared on-site oris from approved commercial facilities. [X[Yes Q No <br />Name of facility: _____—-------------Phone. (--- <br />Address of facility:_______ _______________— <br />I am providing a booth with the following: (to protect my unpackaged food and food-preparation <br />dust and the public) <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 />asphalt, clean tarps and smooth wood are acceptable) and constructed to separate food and food preparation <br />areas from the public. <br />Altemate: ( <br />tamales, cooked beans, rice, <br />Electricity is provided for my booth’s use: Yes 0 No <br />I am providing an accurate probe thermometer to measure the hot and cold <br />foods during all times of booth operation: J^Yes No <br />1 1116 falling hot temperature control for the hot holding of all potentially hazardous foods above <br />fc] Camp stove □ sterno & hotel trays <br /> Double steamer Q stearn teb|e & |ids <br />SI Electric stove top Other (specify) <br />Note: Examples of potentially hazardous f - <br />vegetables, potato salad, eggs, and dain/ prod^