HomeMy WebLinkAboutTemp Food Inspection 150 Nevers Road (5) 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 1
Name of Event
Date of Event lo
Time of Event `- a2_,�
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Location of Event
Event Coordinator
Event Coordinator Address
Event Coordinator Phone# 4u 'l g- L to /oC 3 3
Event Coordinator E-Mail Address j • i LIp
Event Coordinator Phone# (cell, work &home)
Name of Applicant --ILL / )
Name of Applicants Business (please indicate if mobile vendor)
Applicants Address
Applicants E-Mail Address
Applicants Phone# (cell, work&home)
Set up time ;0h
Please provide the following: (If any of the following does not apply to you put N/A)
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.
2. Describe specifically how frozen, cold, and hot foods will be transported to the event.
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3. List all places (name &address)where meats,poultry, seafood, shellfish, and ice will be purchased.
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4. List names,phone numbers, addresses, and shifts to be worked of all employees. See 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.
7. Describe how and where utensil/equipment washing will take place. If no facilities are available,
describe how alternate steps will be taken.
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8. Describe how wastewater will be collected, stored and disposed.
9. Describe the number and location of garbage containers.
containers.
10.Describe what heat source will be used to keep hot foods hot(140 degrees and above).
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11.Describe how colds foods will be kept cold(45 degrees and below).
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12. Describe how food temperatures are monitored.
13. Will foods be prepared on site? If no, where will foods be purchased? (enclose a copy of food
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