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HomeMy WebLinkAboutTemp Food Inspection 501 Evergreen Walk �©'NN ��qt TOWN OF SOUTH WINDSOR $�N�S0.R.�a��4 VENDOR APPLICATION AND GUIDELINES FOR TEMPORARY FOOD SERVICE EVENTS RECEIVED MAY 10 2010 SOUTH WINDSOR ENGINEERING DEPT. JAStrawberry Fest\TownofSouthWindsorTemporaryFoodVendorApplication.doc VENDOR APPLICATION FOR TEMPORARY FOOD EVENT The VENDOR of each temporary food event must complete this application and must be filed 14 days prior to the opening event. This application must be submitted to the Town of South Windsor Health Department, 1540 Sullivan Avenue, South Windsor, CT 06074. This application is not a license. Temporary food permits will not exceed a period of 1 to 5 days. Today's Date .S Zvi o Name of Event �a vJ S o n ihe- 11ro m e-n o'dk e. - 4!!�✓e f q re e o Uiv l k Date of Event _ S 2-7- 'Z G 10 Time of Event Location of Event ergrcen GQC, �•: J�\ Event Coordinator f- G f c n&7 '-Z e t u Sk Event Coordinator Address Y61 a)j 5,);4 SO_) ,� W�/l 01- ct Event Coordinator Phone# c3( O 4 3 2 ,- 3 3 9 !8 ee X 1- 101 Event Coordinator E-Mail Address Event Coordinator Phone#(cell,work&home) Name of Applicant M , k Z A \�e Name of Applicants Business (please indicate if mobile vendor) LU kcon ke++le 60 r n Applicants Address S'p6 P-0,✓en c No(,+ln G-("oS Vert y-A& ( e- c T v 6 2 SS Applicants E-Mail Address ► 3 o\\ V\ ($ y a k 00 , CCU ►� Applicants Phone# (cell,work&home) a C O - 3 I � - 4 2 Lf gj Set up time 8 .00 0'.. Please provide the following: (If any of the following does not apply to you put N/A) 2 1. List all food and beverage items to be prepared and served(menu). Attach a separate sheet if necessary. NOTE: Any changes to the menu must be submitted to the Health Department 10 days prior to the event. PO COnV'\ P°I' Prorane k-,94 e_ CD1) - 2. Describe specifically how frozen, cold, and hot foods will be transported to the event. lA 3. List all places (name &address) where meats,poultry, seafood, shellfish, and ice will be purchased. N I ►� 4. List names,phone numbers, addresses, and shifts to be worked of all employees. See attachment#1. ke AIIeA S60 3J5- y79"b 5. Use attachment#2 in this packet to sketch a drawing showing the event area and where your operation will be. ` S b uc ks b v', ;✓�� �UA I D �.e A-\ 2 6. Describe the number, location and set up of handwashing facilities to be used by employees. 7. Describe how and where utensil/equipment washing will take place. If no facilities are available, describe how alternate steps will be taken. tA N� v+tnS', I S c�`f t I b�- k�r� hove- -t o r 1eC-A� 8. Describe how wastewater will be collected, stored and disposed. AA- , 9. Describe the number and location of garbage containers. yye(+- +o 10. Describe what heat source will be used to keep hot foods hot(140 degrees and above). NIA 11. Describe how colds foods will be kept cold(45 degrees and below). N //A 12. Describe how food temperatures are monitored. NSA 13. Will foods be prepared on site?If no, where will foods be purchased?(enclose a copy of food license) yes a"-N S,-fie 3 ATTACHMENT #1 LIST OF INDIVIDUALS HANDLING FOOD NAME OF EMPLOYEE PHONE# ADDRESS SHIFT 866 3/S- 2'�8 sob �mvQ�efle I. Mike— /- Ile n w, Gr®svpAorrdale, �6 2Ss, 2. 3. 4. 5. 6. 7. 8. 9. 10. 4 ` ATTACHMENT #2 CHECKLIST FOR FOOD BOOTH/VENDOR OPERATORS Metal probe thermometer(0—220 degrees F range) Thermometers for all refrigerators Coolers and ice packs (if ice is to be used for cooling of foods,where is water to be drained) Plastic wrap/Aluminum foil Extra utensils: tongs, spatulas, spoons, and knives Water source Buckets/tubs for washing, rinsing, sanitizing food equipment Bleach for sanitizing,test strips for checking Waste water disposal container Container(s) for grease collection Clean wiping cloths and a container to store them in Garbage containers and plastic bags Hats/hair restraints Crates, shelves to store food off of the ground Gloves for food handling Hand washing station 5 Page 1 of 1 s iso. eeri' � Q as.s+t s met the ece ssa-r 'rementsfor `* .Food ?- anq er Certification. 1701 n AJ�.:a'1J a �. � ,.)ii*'-V JCe- For Food Pr otecti0 1 r 519-84'48- 4 7 Exam ate: 4/16/05 Experior. AssessmentSTM, EEC ; 800.624.2736 http://69.147.103.179/us.f639.mail.yahoo.corn/ya/securedownload?fld=Inbox&mid=1 1902... 5/6/2010