Laserfiche WebLink
3 <br />5 <br />bottled water. <br /> On-site hose bib that is connected to a potable water source. <br />O Other (specify) : <br />Bedridfy is provided for my booth’s <br />nwatt, tunata*, cootad b«mfioMpto of pototrtMy iNHMkNM food Include:K <br />i niHMw, potato «M 009*, end (Wry product*. <br />use: ETVes No <br /> Stemo 4 hotel trays <br />Q Steam tabte&Ms <br /> Other (specify) <br />[Cemp stove <br />Doufcfe stoamer <br />aecMcatoustop <br />o Other (specify):_____—---------------------------------------- ---------------------------------- <br />Note: The only operations not required to provide enclosed booths are those which sefi beverages from <br />approved d^pensers, or prepackaged foods from approved sources. <br />Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods. <br />TEMPORARY FOOD VENDOR’S APPLICATION <br />AS fcatf *■■■«■■* Wcdb tor anA are required to return a signed and completed copy of this checkkst to <br />•»WsteWaaaa*aa*Bri^^»43|«HBe0cspriortothKe>rt9<<. ----- <br />t VI— me rr»n—<■ furczPfyAjc _________bate(8): <5~- <br />Z aa ■—■■■■Aon ataout my organization/bt^iQeBs: <br />—reef I — < Illi Fl __________________________________________ <br /> AriMMK _ <br />> <3 ^5^- 2_______ &xxxvei0&. ( )_______ _ _________________ <br />Laf teWtobesoAdcrgreen to the public: _ Zt^ /-bu) 22c r 3__________ <br />fAMfiiMrt—n food that is NOT prepared at home: ^Yes No <br />AVfoodas prepared on-site or is from approved commercial facilittes. O Yes O No <br />Mirer cttacBty: ......................................................................... ......Phone: {_____)------------------------ - ------------ <br />Adkfress of fodfty:______________________________________________________________ ___ _________ <br />I am providing a booth with the following: (to protect my unpackaged food and food-preparation areas from fires, <br />dust and the public) <br />EfA booth with walls and ceiling constructed of either wood, canvas, plastic, similar material and fine mesh fiy <br />screening, completely enclosing open food areas. It will also have a smooth and deanabie floor (concrete. <br />asphalt, dean tarps and smooth wood are acceptable) and constructed to separate food and food preparation <br />areas from the pcfofc. <br />/ am providing an accurate probe thennometer to measure the ho* and coto holding of pctertialty harart <br />fryrtit during al UmeB of bootti operation: Yes 0No <br />am prwHfag the fofowfog hat temperature control for the hot holding of all potenSaBy hazardous foods si <br />lasr.