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Home My WebLink AboutTemp Food Inspection 150 Nevers Road (2) DOR 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 April 29, 2009 Name of Event Evening in the Park Date of Event May 16'h 2009 Time of Event 5:00pm 9:00pm Location of Event Nevers park Sand hill rd South Windsor Ct 06074 Event Coordinator Kent Carlson Event Coordinator Address 970 Avery St South Windsor ct 06074 Event Coordinator Phone# 860-250-6554 Event Coordinator E-Mail Address kcarlsonl2l@aol.com Event Coordinator Phone#(cell,work&home) 860-250--6554 C:ame me of Applicant an Macgregor o Applicants Business (please indicate if mobile vendor)N.A. Applicants Address 18 Gordon aver Enfield ct 06082 Applicants E-Mail Address ianmac3 I @cox.net Applicants Phone#(cell,work&home) 860-604-9212 Set up-time between 12:30pm and 1:30 0 Please provide the following: (If any of the following does not apply to you put NIA) l.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. Hotdogs,Hamburgers, Cheeseburgers, Potato chips,Soda, Water, Ice cream sold from Ice-cream truck on site 2. Describe specifically how frozen,cold,and hot foods will be transported to the event. Food will be transported in coolers,which will be iced down.No hot food to be transported an everything cooked to order. 3. List all places (name&address)where meats,poultry, seafood, shellfish, and ice will be purchased. Cosco foods Enfield ct 06082 Big Y supermarket Enfield ct 06082 4. List names,phone numbers, addresses, and shifts to be worked of all employees. See attachment#1. On attachment#1 5. Use attachment#2 in this packet to sketch a drawing showing the event area and where your Operation will be. 6. Describe the number, location and set up of handwashing facilities to be used by employees. 1 hand washing station. Water cooler with hot water,hand soap with a bucket to collect wastewater And paper towels to dry hands 2 . Describe how and where utensil/equipment washing will take place. If no facilities are available, Describe how alternate steps will be taken. Utensils will be washed back at Eddies . Ice-cream facility in their dishwasher. During Event they will be wiped down with sanitizing wipes if needed 8. Describe how wastewater will be collected, stored and disposed. Wastewater will be collected in 5gallon buckets covered and brought back to Eddies Ice-cream to be disposed of properly 9. Describe the number and location of garbage containers. 2 cans one behind cooking area for cooks trash, one out front near condiment table for public use There will also be other cans available thru out the park during the event 10. Describe what heat source will be used to keep hot foods hot(140 degrees and above). Food will be cooked to order on an 8-burner gas grill 11. Describe how colds foods will be kept cold(45 degrees and below). Cold foods will be kept on ice in coolers.All raw food and cooked food will be stored in separate coolers with ice. 12. Describe how food temperatures are monitored. Food is cooked to order and will be checked with a metal probe thermometer. 13. Will foods be prepared on site?If no,where will foods be purchased? (Enclose a copy of food license) Food will be cooked to order on site. 3 NAME OF EMPLOYEE PHONE# ADDRESS SHIFT l.Rallene Phillips 463-9265 Ellington ct All 2.Jerry Byers 749-9267 Enfield ct All 3. Steven Breault 798-8751 Ellington ct All 4. 5. 6. 7. 8. 9. 10. 4 ATTACHMENT #2 6 CHECKLIST FOR FOOD BOOTH/VENDOR OPERATORS x 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) x Plastic wrap/Aluminum foil x Extra utensils: tongs, spatulas, spoons, and knives Water source x Buckets/tubs for washing,rinsing, sanitizing food equipment Bleach for sanitizing,test strips for checking x Waste water disposal container x Container(s) for grease collection x Clean wiping cloths and a container to store them in x_Garbage containers and plastic bags Hats/hair restraints Crates, shelves to store food off of the ground x Gloves for food handling X Hand washing station MOBILE VENDOR CHECKLIST VENDOR NAME OWNER NAME LICENSE PLATE TYPE OF VEHICLE FOOD CLASSIFICATION OWNER ADDRESS HOME PHONE CELL PHONE E-MAIL QQQFO NAME APPROVED BASE OF OPERATION N/A_MENU CLEARLY VISIBLE NL CURRENT MOTOR VEHICLE REGISTRATION(TEMPORARY REGISTRATION NOT ACCEPTABLE) N/ VEHICLE CLEAN AND FREE OF ODORS J ALL EQUIPMENT CLEAN AND OPERABLE GRILL(S)ENCLOSED AND PROPERLY VENTED ? PROTECTION FROM AIRBORNE CONTAMINATION AND INSECTS PROPER HAND WASHING `/ APPROVED SANITARY GLOVES(If Applicable) J HOT&COLD WATER PROVIDED&WASTEWATER COLLECTION J PROPER THERMAL EQUIPMENT TO HOT HOLD AND/OR COLD HOLD PROPER THERMOMETERS: TYPE&AMOUNT,ALCOHOL WIPES J TRASH CONTAINER(S)WITH COVERS J CLEANING&SANITIZING CHEMICAL PRESENT-PROPERLY STORAGE f ADEQUATE UTENSILS PROVIDED(SPOONS,SCOOPS,LADLES,ETC) J ADEQUATE SINGLE SERVICE STORAGE/DISPENSING Notes: S1 0 SIGNASANITARIAN *Prior t M.P.inction, all mobile vendors shall complete the Mobile Vendor application. Once the application has been reviewed and approved, a scheduled Sanitary Food Service Inspection can be arranged. Upon satisfactory completion of a Sanitary Food Service Inspection,The Town of South Windsor Health Department will allow the sale of food products. Failure to complete these requirements may result in fines,fees and/or closure of the Mobile Vendor. WAHealth Department 2008\Forms\Mobile Vendor Checklist.doc Page 3 of 7 VENDOR APPLICATION FOR TEMPORARY FOOD EVE11 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 license. Temporary food events will not exceed a period of 1 to 5 days. Today's Date April 8th 2010 Name of Event Evening in the Park Date of Event May 15th 2010 Time of Event 5 PM to 9PN1 Location of Event Town Of South Windsor Nevers Park Event Coordinator Kent Carlson Event Coordinator Address 970 Avery Street South Windsor CT.06074 Event Coordinator Phone# 860-250-6554 Event Coordinator E-Mail Address kcarlsonl2l@aol.com Event Coordinator Phone#(cell, work&home) N/A Name of Applicant Ian MacGregor , Name of Applicants Business(please indicate if mobile vendor) N/A Applicants Address 18 Gordon Ave Enfield Ct Applicants E-Mail Address iamnac31@cox.net Applicants Phone#(cell,work&home) Cell 860-604-9212 Setup time Saturday Mayl 5th 1 P1VI 4/9/2010 Page 5 of 7 6. Describe the number, location and set up of handwashing facilities to be used by employees. 1 Hand washing station next to the food prep area 7. Describe how and where utensil/equipment washing will take place. If no facilities are available, describe how alternate steps will betaken. Utensil washing will be done at Eddies Icecream EastWindsor Ct _8. Describe how wastewater will be collected, stored and disposed. All waste water will be collected in 5gallon buckets with lids and disposed at Eddies Icecream east in EastWindsor Ct 9. Describe the number and location of garbage containers. 3 cans for rubbish will be Distributed around or site for public and our use 10. Describe what heat source will be used to keep hot foods hot(140 degrees and above). All foods are cooked to order 11. Describe how cold foods will be kept cold(45 degrees and below) All foods will be kept in coolers covered with Ice 12. Describe how food temperatures are monitored,cleaned and sanitized. Food temps will be checked with metal food probe and wiped with sanitizing wipe 13.Will foods be prepared on site?If no, where will foods be purchased? (enclose copy of food license) Food will be prepared on site to order 4/9/2010 Page 7 of 7 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 4/9/2010 Page 1 of 7 Lipe, Michele From: Ian'MacGregor[ianmac31 @cox.net] Sent: Thursday, April 08,2010 9:38 PM To: Lipe, Michele Subject: Temporary Food Vendor Application for May 15th 2010 Evening in the Park Attachments: header.htm VENDOR APPLICATION AND GUIDELINES FOR TEMPORARY FOOD SERVICE EVENTS 4/9L2010 Page 1 of 1 Lipe, Michele From: Hall, Judith Sent: Thursday,April 01, 2010 8:34 AM To: Lipe, Michele Subject: FW:vendor application Director of Human Resources Town of South Windsor South Windsor,Connecticut Phones 860.644.2511,Extension 201 E-mail:Judith.Hall@southwindsor.org From:Ian MacGregor [mailto:ianmac3l@cox.net] Sent: Wednesday, March 31, 2010 9:28 PM To: Devito, Robert Subject:vendor application Hi Bob this is Ian MacGregor from the Town garage ,I am doing the Evening in the Park again this year May 15th . I tried to find the Application on line for temporay food service events but cant seem to find it on line,can you please send me the link so that I can fill it out on line and send it to you, or you can just change the date from last years application, cause nothing is going to change( I know you cant do that) Thanks Ian MacGregor 4/1/2010