Laserfiche WebLink
6 <br />FOOD VENDOR’S APPLICATION <br />- <br />5 _s txsr sd 33 scad <x given to the public: <br />4 <br />5. <br />Other (specify): <br />6. <br /> On-site hose bib that is connected to a potable water source. <br /> Other (specify): <br />Yes NoElectricity is provided for my booth’s use:7. <br />8. <br />9. <br />meats, tamales, cooked beans, rice, <br />TEMP EVENT APRPage 7 of 11 <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 />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 /> Camp stove <br /> Double steamer <br /> Electric stove top <br />EHD 16-02 <br />7. •4'15 <br />I am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br />135°F: <br />Note: Examples of potentially hazardous food include: <br />vegetables, potato salad, eggs, and dairy products. <br />pcvy pgkZ/gn Date(s): y <br /> Stemo & hotel trays <br /> Sfeam table & lids <br />0Other (specify) <br />Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods: <br />fj Approved bottled water. <br />I am providing an accurate probe thermometer to measure the hot and cold holding of potentially hazardous <br />foods during all times of booth operation: Yes No <br />M j-stckxs <^017 ts,- -reft arc "•cn-pfcft- are required to return a signed and completed copy of this checklist to <br />ts .• oricr to this event <br />1 P^it 'e/desice., <br />T-& s rre*—aicout my erganization/business: <br />flfeFWCSf t>'jsness: /'ZAl/c’rJ op __________ <br />/OS'f)/) ^/'OtCood [)h- Cc>^ <br /> Alternate: ( <br />i sr ^wsr&ig food that is NOT prepared at home: [vjYes No <br />AS fxxs @ prepared on-site or is from approved commercial facilities: EjYes No <br /> ."'tenre ex fadtity: a 6cVT7 C a r I GV71 />/ / s <> <-j Phone: / <br />Address of facility: p 5h>cPPr>fl <br />L' / <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) <br />)_____________________________ <br />lyie^icb^bk:,' / prmc h-e^ fco'lekv <br /><7 CTO