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TEMPORARY FOOD VENDOR’S APPLICATION <br />1.I.Name of Event r- Date(sy. <br />2. <br />Address: <br />3. <br />4. <br />5. <br /> Other (specify): <br />Approved water for drinking, utensil and hand washing will be provided m my booth by the foSowing methods:6. <br />7. <br />8. <br />9. <br />meats, tamaies, cooked beans, rice, <br />TEMP tVENT APPPage 7 o» 11 <br /> 5 <br />Q Canrqj stove <br />Double steamer <br /> Electric stove top <br />^ote: The only operations not required to provide enclcsed booths are those which seE beverages from <br />approved dispensers, or prepackaged foods from approved sources. <br />Q Stemo & hotel trays <br /> Steam table & lids <br />r~l Other (spsofy) <br />A booth with walls and ceiling constructed of either wood, canvas, piast'c, similar material and fine mesh fly <br />screening, completely endosing open food areas, tt wSl also have a smooth and deanabie Soar (concrete, <br />asphalt, clean tarps and smooth wood are acceptable) and constructed to separate food and food preparation <br />areas from the public. <br />Approved botfled water. <br /> On-site hose bfo that is connected to a pctabte water source. <br />Alternate: ( ). <br />SHO 1&O2 <br />7Z28/10 <br />Afl food vendors (both for profit and non-profit) are required to return a staled and completed copy of this checkfist to <br />the festival coonfinator three (3) weeks prior to this event <br />Note: Examples of potentially hazardous food inchide: <br />’ vegetables, potato salad, eggs, and dairy products. <br />The following is information about my organization/business: <br /> Other (specify):-------- <br />Electricfty is provided for my booth’s use: S| Yes O No <br />I am providing an accurate probe thermometer to measure the hot and cold hokfing of potentiafiy hazardous <br />foods during all times of booth operation: QjYes No <br />I am providing the following hot temperature control for the hot hokfing of ail potentially hazardous foods above <br />135’F: <br />Name of organizationfousffiess:i <br />75// <br />P?K)ne: <br />List food to be soM or given to the pifofic: <br />I am providing food that is NOT prepared at home: Yes Q No <br />All food is prepared on-site or is from approved oomfnerctal fedSties: 25 Yes O No <br />Name of fadiity: "Tato CLrertAJH Phone: <br />Address of fedSty^^^VZI^ <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)