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TEMPORARY FOOD VENDOR’S APPLICATION <br />2 <br />AiXJnfM <br />{ v3 <br />4 <br />5 <br /> Other (sp*aty) <br />8 <br />FJ On-xtB ho»e b* that is connected to a pot3i*e water source <br /> Other (sweaty). <br />1 <br />B <br />7 <br />."l.UP EVfiMT A/11'tr<) M O,’ l&’SrtX <br />Note- The only operotinns rsx oKjcwrod to provxie eocurwo boettvi »c trtose wt-«h sett Ikv«« »yi*n trcm <br />ooprrn/ed diepeneers. or pr«*e<Jte9eo foods from a»xove<J sources. <br />I ant proving the foSoveng hot temperature control tor the not ixyar^ erf eil potential* haz»<Vx» foods abwe <br />135'F.Z <br />I am providing food thet is HOT propered st home [’^Ves LI No <br />All food i* prepared orr-»*e or a from sqxoved crmrnenial tuoutres <br />Name of t»d*ty . . ___________________________ <br />Address otfadhty__________________________ ___________ <br />Approved wwter tor drvrKing uteo»> snu hand washing wM be provided n my booth by the fotwwing methods <br />[□'Xpprovad Dotttod watur <br />QJtamp stove <br /> Duutote steamer <br />rj EJectnc wove top <br /> Stemo & hotel trays <br />Steam table A hda <br /> Other (speofyj <br />□'Yes No <br />_Phaw i___ <br />I am providing a booth wth the toftoMop (to protect my ixipectraged toeo and food preperatiS'i areas from flies <br />dust an^.the puMc) <br />PlK boudi with waits and c»Jlng oamrudad ot iNlhrx wood, canvas, plastic, sunilai material and fine mesh fl* <br />ivrworeng compietefy arxiorog open food areas It wv> also have a srrtooth and cleanable floor (conacte <br />aaohart a»«i tarps and smooth wood ara aowpteble) and constrocted to separate food and food preparacon <br />areas *rcm the public. <br />Note. Hvrr*rfM of potentially haaardou* rone Ineluda- <br />vagateUae. potato aalad, agg*. and dairy product*. <br />Elaeinaty is provided tor my booth s uw YesCMo <br />Al food vendoe (both (or profit and txxv-profrf) are roqured to nMutn a sfgrwg and compiled copy d this che<*>»t to <br />the faattval coordinator ttroe (3) ww*» poor to this avert Thursdays <br />nt Even Market on Maple . May - Oct <br />The WtoiMriy r* foformabun abcut my orpanjeluri’txjSinesa <br />Name rf organiztrlionAM»iness VM_~/ k G -", ■•, '-> Qi' 1 j CfyQ? C '■) <br /> <br /> Alternate ( ; <br />} k t' »XA </e ■-•?■* <br />I am providing an accurate probe thermarr«ts*to measure the hot and cold holding oi potentiaH* rwanix;' <br />food* rkirng s* tunes of baolh operaooc. O'Ya* [3 Na <br />Phone (Q ?S~i '-V, i t ~ .-’■L S'1'-/ <br />UM food to be sod or given to the puEfic "“Va;' - X <br />rwat*. ronkad beans, rice.