Laserfiche WebLink
TEMPORARY FOOD VENDOR’S APPLICATION <br />Date(s): 6 te 'Jb j)<901 bI.Name of Event:1. <br />2. <br />Address: <br />(art)Phone: <br />3. <br />4. <br />5. <br /> Other (specify): <br />6. <br /> Other (specify): <br />7. <br />8. <br />9. <br />meats, tamales, cooked beans, rice, <br />TEMP EVENT APRPage 7 of 11EHD 16-02 <br />7/14/15 <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 /> Stemo & hotel trays <br /> Steam table & lids <br /> Other (specify) <br />Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods: <br />[ZfApproved bottled water. <br />(zfon-site hose bib that is connected to a potable water source. <br />Av\(A <br />Electricity is provided for my booth's use: [ZfYes No <br />All food vendors (both for profit and non-profit) are required to return a signed and completed copy of this checklist to <br />I am providing a booth with the foltowing: (to protect my unpackaged food and food-preparation areas from flies, <br />dust and the public) <br />□^A booth with walls and ceiling constructed of either wood, canvas, plastic, similar material and fine mesh fly <br />screening, completely enclosing open food areas. It will also have a smooth and cleanable floor (concrete, <br />asphalt, clean tarps and smooth wood are acceptable) and constructed to separate food and food preparation <br />areas from the public. <br />Note: Examples of potentially hazardous food include: <br />vegetables, potato salad, eggs, and dairy products. <br />the festival coordinator three (3) weeks prior to this event. <br />CrkilXXcK CAx.V\ <br />I am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br />135’F: <br />E'fcamp stove <br />G/fOouble steamer <br /> Electric stove top <br />The following is information about my organization/business: <br />Name of organization/business: <br />I am providing an accurate probe thermometpr to measure the hot and cold holding of potentially hazardous <br />foods during all times of booth operation: 0 Yes No <br />(\)€fYX__________ Alternate: (c^LCft) H I <br />List food to be sold or given to the public: LaJoVcY I <br />I am providing food that is NOT prepared at home: 0Yes No <br />All food is prepared on-site or is from approved commercial facilities: Q^Yes El No <br />Name of facility. - G-rl dJOvri-S ^0^ Phone: <br />Address of facility: .“S • (nurlim