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Temp Food Inspection 00 Evergreen Walk (2)
September 8, 2008 Paul Petrillo Wapping Fair P.O. Box 486 South Windsor, Ct 06074 Re: Temporary Food Vendors at the Wapping Fair, South Windsor, CT Dear Mr. Petrillo: It was a pleasure working through the issues and planning for the food vendors for this year's Wapping Fair. I would like to thank you for your untiring effort and cooperation you put forth in supporting concerns this office had. However, on September 4,2008,this office inspected the food vendors and has provided you the following list by Vendor of noted deficiencies that will be required to be resolved for next years Fair: 1. Vinci Concessions a. Toxic chemicals stored all over food prep area b. Hood very dirty c. Dough mixer had oil leaking from the mixer d. Moldy rags in sink. e. Tomato sauce heated in crock pot. f No three bay sink. g. No sanitizing,no sanitizer,no test kit h. Ben did not have a hair restraint 2. South Windsor Republicans a. No means to wash rinse and sanitize b. No extra utensils to replace soiled utensils 3. Giggles a. Food equipment was very dirty b. No means to wash rinse and sanitize c. No sanitizer d. No extra utensils. e. Open food containers f. No hand wash set up 4. Roma Restaurant a. Did not cover bread, sauce, oil, and vinegar that public would serve themselves b. No extra utensils 5. CDR a. No hair restraints. b. Hollow stirrers for coffee c. No means to wash rinse and sanitize d. No extra utensils 6. South Windsor Cheerleaders a. No hair restraints b. No means to heat(used crock pot) c. No means to wash rinse and sanitize d. No sanitizer e. No extra utensils f. No shelves to store food containers off of the ground 7. Jaycees a. No means to wash rinse and sanitize b. No sanitizer c. No means to hot hold d. No means to heat chili (used crock pot) e. Self service pickles,no tongs,no means to cover 8. Indochine Pavilion a. No means to wash rinse and sanitize b. No sanitizer c. No extra utensils 9. Jacks Fires a. Cut potatoes not kept at 45 degrees b. Three bay too small for baskets c. Hood very dirty d. Floor very dirty In an effort to ensure all food vendors have enough time to adjust unresolved issues and to ensure that the Public Health Code Requirements have been met,the Town of South Windsor will be requiring that all vendors be set up and ready for inspection no later than two hours before the fair opens. If the vendor is not ready or if there are deficiencies noted that cannot be resolved the vendor by 4:OOpm on Thursday,the booth will be red tagged and will not be allowed to open until Friday. To assist each vendor, this Office will provide a checklist with next years applications so that all vendors will know what is expected of them. This years fair has been a learning experience for all of us and I look forward to working with you again next year. If you have any questions,please feel free to call me. Respectfully, Robert De Vito, R.S. Environmental Health Officer • VENDOR APPLICATION FOR TEMPORARY FOOD EVENT The VENDOR of each ternporary 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 aimlication is not a license. Temporary food permits will not exceed a period of I to 5 days. Today's Date Name of Event Wapping Fair____ Date of Event Sept. 7th Time of Event 914 6 p.m.p.m.9 0 51 DO r F.111. — .1 J P.nl. 9/0" is 9/7 10 a.m. —6 p.m. Location of Evens Evergreen VValk fbehind LA Fitness) Event Coordinator—Paul Petrillo Event Coordinator Address POBox 486 South Windsor, CT 06074 Event, Coordinator Phone# 860-573-6780_ Event Coordinator E-Mail Address wappingfair@.aol.com .-,Ifa Event Coordinator Phone# (cell, work& home)_(C) 0-573-6780 (IT) 860-632-1544 Name of Applicant__[Z o 6 60 ke4 6e Let)no Name of Applicants Business (please indicate if bile vendor) Applicants Address Applicants E-Mail Address ,Vpli can't s Phone 4 (cell, work&home) Set up time-TILY5- —� l LI —A& Please provide the following: (If any of the following does not apply to you put N/A) I.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 frozenVM, old, and hot foods will be transported to the event. / 3. List all places(name& address) where meats, poultry, seafood, shellfish, and ice will be purchased. 19, 4. List names, phone numbers, addresses, and shifts to be worked of all employees. See attachment #1. /Vbt 5. Use attachment#2 in this packet to sketch a drawing showing the event area and where your operation will be. Wapping Fair will provide layout the week of the fair. 6. Describe the number, location and set up of handwashing facilities to be used by employees. CT 7. Describe how and where utensil/equipment washing will take place. If no facilities are available, describe how alternate steps will be taken, 2 S. Describe how wastewater will be collected, stored and disposed. &C((t7t D Sly 9. Describe the number and location of garbage containers. Wapping Fair will have garbage containers located in area surrounding food areas fk 10. Describe what heat source will be used to keep hot foods hot (140 degrees and above). .11. Describe how colds foods will e kept cold(45 degrees and below). AM 12. Describe how food temperatures are monitored, clearted and sanitized. W 1 ). Will foods be prepared on site? If no, where will foods be purchased? (enclose copy of food license) Town of South Windsor Health Department Telephone(860) 644-2511 Extension 248 Temporary Event — Food Inspection 71J Fj,, s Name of Organization: Phone No.: Cell No.: 2,03-X-1 t- ZZ 4 Person-in-charge (PRINT): 1a- %-,,,�,.., -11, Name &Address of Event:_ e7vvy.(.e re r !L,�,6 F;o" Date(s) of Event: 9-q-Old ;Z q - 7-o'�e Hours of Operation: co- t ♦ Hand Washing Setup: sc2 ♦ Waste Water/Garbage Disposal: ib w,.j Z ♦ Approved Food&Water Source: n�.mac �,sw. ze Za Mv�,c n- , ��� �c>S j- Clot c� ♦ Personal Hygiene:_ ,7,�s Fo Q ,,4s p�ci1 o s�S ♦ Thermometers/Alcohol Swabs: N' .6, ♦ Cold Temps(45°F or colder): 1 C A o Q ♦ Coolers: 6 N S. ` ♦ Hot Temps(140°F or hotter): N/A ♦ Internal Cooking Temps: N A CHECK FOOD TEMPERATURES THROUGH-OUT THE DAY*USE YOUR PROBE THERMOMETER ♦ Off-Site Preparation: Approved Commissary/ Licensed Kitchen: W ♦ Cross-Contamination: Utensil Washing: 5vkc``YZ.. Tb 3c A gas vSgb ♦ Sanitized Wiping Cloths: ♦ Food/Equipment/Single-Use Protection: o-✓z ♦ Self-Serve Food/Utensils Protected: Ao-,_ cott. ♦ Proper Construction/Smooth Cleanable Surfaces: o ♦ Workers Log (Name, Address, Phone#, Dates &Times Worked) Keep for 90 days 1C CORRECTIONS DUE IMMEDIATELY Ft3-?- 9 b�j g ♦ Other: 1SL%Ec t c a 4 s. cr..4 C_�P .3��C' sw 3ti o c..+�2 So I Ac c ee S . 7- f Food Safety information on Reverse Side I have read and hereby agree to foll the d S ety Information listed on the reverse side of this form. PERSON IN CHARGE (Sign): Date: ^` -- 01 Inspector: I�Lry I f.3 1� A i`+-1 A �� Date: 91q, '�l lO$' END OR APPLICATION rOR 'TEmPoRARY roOD EVENT The VENDOR of each temporary food event must complete this application and must be filedd.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 -77- o o IL Name of Event Wapping Fair Date of Event Sept. e-7th Time of Event 9/4-6 p.m.-10 p.m.; 9,15 6 p.m. - 11 p.m. 9,16; 10 a.m. -11 p.m.; 9/7 10 a.m. -6 p.m. Location of Event Evergreen Walk(behind LA Fitness) Event Coordinator Paul Petrillo Event Coordinator Address PO Box 486 SouthWindsor, CT 06074 Event Coordinator Phone# 860-573-6780 Event Coordinator E-Mail Address wappingfair(�,"7a aoi.com Event Coordinator Phone#(cell, work&home)_(C) 860-573-6780(H)860-632-1544 Name of Applicant S4 `) (n(� Name of Applicants Business(please indicate if mobile vendor) u y\n� j—"C- r Applicants Address w — a��3 - -1a.0 ��(� Applicants E-Mail Address A41V\h (.1 - q y ` • C m Applicants Phone#(cell,work&home) Set up time J:0 vim A- 4' 0 Please provide the following: (If any of the following does not apply to you put N/A) 1.List all food and Leverage 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. Co 46YN CLL"Q C(x"d A9 k am'd it's 1 c 2. Describe specifically hoNv frozen, cold, and hot foods will be transported to the event. Pt 3.List all places(name&address)where meats, poultry, seafood, shellfish, and ice will be purchased. Qy WC� t CIL off- a `Oc yo(Q,y 4. List names,phone addresses, and shifts to he worked of all employees. See attachment 41. c� 12 v\ y� CI s1�� r<- CT 6(12WO S. Use attachment 42 in this packet to sketch a drawing showing the event area and where your operation will be. Wapping Fair will provide layout the week of the fair. 6. Describe the number, location and set up of handwashing facilities to be used by employees. N OQ �k o -�1rc ' 4�� `v� ���n�; v�% YQ VA V)l Ong G-V)J- C"oA.V Lj)t'\ - uxAtW-0- is. 7. Describe haw and where utensil/equipment washing will take place. If no facilities are available, describe how alternate steps will be taken. 1 S. .Describe how wastewater will be collected, stored and disposed. VnO lAi V V� �Cy 9. Describe the number and location of garbage containers. Wapping Fair will have garbage containers located in area surrounding food areas 10. Describe what heat source will be used to keep hot foods hot(140 degrees and above). R A 11. Describe hoYw'colds foods will be kept cold (45 degrees and below). 12. Descri e how food temperatures are monitored, cleaned=and sanitized_ R )1- b v\ ��d Aexy\95,. bA we-, U ae-- c , a U &Y 66 WI M46 13. Will foods be prepared on site? If no, where will foods be purchased? (enclose copy of food license) l t aoc�S cam. red ye. Om �S L - c 1� NIAME OF EMPLOYEE PF ONT i4 ADDRESS SHIFT 3. NA iye, CT C)ce 4 o 4. s. 6. 7. s. 9. I0. ATTACHMENT 42 CMCKL ST Fi. k FOOD ]BOOTHNENDOR OPERATORS Metal probe thermometer(0—220 degrees F range) / Thermometers for all refrigerators V Coolers and ice packs (if ice is to be used for cooling of foods, where is water to be drained) Plastic wrap/Aluminum foil V Extra utensils: tongs, spatulas, spoons, and knives I 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. V/ Clean wiping cloths and a.container to store them in 4 V Gasbag€;containers and plastic lags Hats/hair restraints Crates, shelves to stare food off of the ground Gloves for food handling Hand washing station 5 Town of South Windsor Health Department Telephone(860) 644-2511 Extension 248 Temporary Event — Food Inspection Name of Organization: ja CL Phone No.: `�l -610 Cell No.: Person-in=charge (PRINT): Name &Address of Event: Date(s)of Event: —y - flours of Operation: D ---------------- ♦ Hand Washing Setup: ♦ Waste Water/Garbage Disposal: Ap M & ♦ Approved Food&Water Source: 1/ es ♦ Personal Hygiene: ♦ Thermometers/Alcohol Swabs: ♦ Cold Temps(45°F or colder): '1 j9- ♦ Coolers• "Jk ♦ Hot Temps.(140°F or: tter) 0L -- ♦ Internal Cooking Temps: ` CHECK FOOD TEMPERATURES THROUGH-OUT THE DAY♦USE YOUR PROBE THERMOMETER ♦ Off-Site Preparation:Approved Co missary/Licensed Kitchen:_ Qll 000e'4 ♦ Cross-Contamination: Utensil Washing: — ZLgj ♦ Sanitizer/Wiping Cloths. r ♦ Food/Equipment/Single-Use Protection: ♦ Self-Serve Food/Utensils Protected: /�— ♦ Proper Construction/Smooth Cleanable Surfaces. ♦ Workers Log (Name,Address, Phone#, Dates &Times Wo ked) Keep.for 90 days cQ CORRECTIONS DUE IMMEDIATELY ♦ Other: LE A 7— b Food Safety Information on Reverse Side I have read and hereby agree to follow the Food Safety Information listed on the reverse side of this form. PERSON IN CHARGE (sign - Date: Inspector: Date:_ � 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 _8-27-008 Name of Event Wapping Fair Date of Event Sept. 4th—7th Time of Event 9/4 6 p.m.-10 p.m.; 9/5 6 p.m.— I I p.m. 9/6; 10 a.m. -I I p.m.; 9/7 10 a.m. —6 p.m. Location of Event Evergreen Walk(behind LA Fitness) Event Coordinator Paul Petrillo Event Coordinator Address PO Box 486 South Windsor, CT 06074 Event Coordinator Phone# 860-573-6780 Event Coordinator E-Mail Address wappingfair@aol.com Event Coordinator Phone#(cell,work&home) (C) 860-573-6780 (H) 860-632-1544 Name of Applicant_Gary D. Rollins_ Name of Applicants Business (please indicate if mobile vendor)_Jack's Fries -mobile unit Applicants Address_7940 W. Silverleaf Ln. Dunnellon FL 34433 Applicants E-Mail Address_fststroke96@aol.com Applicants Phone#(cell, work&home)_ (w)413-687-8253 Set up time 9-3-08 9-4-08 Please provide the following: (If any of the following does not apply to you put N/A) CTDOCS:25986.1 2 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. Fresh cut French fries Fresh cut potato chips Cold drinks Bottled water 2. Describe specifically how frozen, cold, and hot foods will be transported to the event. n\a 3. List all places (name&address)where meats, poultry, seafood, shellfish, and ice will be purchased. n\a 4. List names,phone numbers, addresses, and shifts to be worked of all employees. See attachment#1. Gary Daniel Rollins 11240 N.Northwood Dr. Inglis FL 34449 413-687-8253 ezeo 751 5. Use attachment#2 in this packet to sketch a drawing showing the event area and where your operation will be. Wapping Fair will provide layout the week of the fair. 6. Describe the number, location and set up of handwashing facilities to be used by employees. Inside my trailer is a 3 comparlient stainless steel si setup and a separate large stainless sink for washing as well. �7 d S m e Al M09-le- ��/,� , • 7. Describe how and where utensil/equipment washing will take place. If no facilities are available, describe how alternate steps will be taken. We use a standard wash, rinse, sanitize procedure in the above described sinks and I am also serve safe certified. 8. Describe how wastewater will be collected, stored and disposed. Wastewater will be collected and stored in holding tanks and disposed of at the appropriate dump site. CTDOCS:25986.1 2 9. Describe the number and location of garbage containers. Wapping Fair will have garbage containers located in area surrounding food areas 10. Describe what heat source will be used to keep hot foods hot(140 degrees and above). I have typical stainless steel fyalators and approved heat lamps. 11. Describe how colds foods will be kept cold(45 degrees and below). n\a 12. Describe how food temperatures are monitored, cleaned and sanitized. I have stem thermometers that are cleaned and sanitized after each use. 13. Will foods be prepared on site? If no,where will foods be purchased? (enclose copy of food license) Yes, all food product is prepared and sold on site. NAME OF EMPLOYEE PHONE# ADDRESS SHIFT CTDOCS:25986.1 3 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. ATTACHMENT #2 CHECKLIST FOR FOOD BOOTH/VENDOR OPERATORS Yes Metal probe thermometer(0—220 degrees F range) n\a Thermometers for all refrigerators _yes Coolers and ice packs(if ice is to be used for cooling of foods,where is water to be drained) _yes Plastic wrap/Aluminum foil _yes Extra utensils: tongs, spatulas, spoons, and knives _yes Water source _yes Buckets/tubs for washing,rinsing, sanitizing food equipment _yes Bleach for sanitizing, test strips for checking _yes Waste water disposal container yes_Container(s) for grease collection _yes Clean wiping cloths and a container to store them in CTDOCS:25986.1 4 J � yes Garbage containers and plastic bags _yes Crates, shelves to store food off of the ground _yes Gloves for food handling _yes Hand washing station CTDOCS:25986.1 5 Harvest. Country 'tchens Harvest Country Kitchens 175 West Road, Ellington, CT Buy ONE Entr e Get Meadow View Plaza 2nt�Entree �� rice* 860 871-2204 (*of equal or lesser !ue) Offer expires (���lOg .Offe catrnnt be Lunch Menu AV NO Available Sides AV combined witb any otber offers o con W Sandwiches wt Grilled Chicken Breast ar$6.99 ,s Potato Salad ar ar Fruit Salad ar s Meat Loaf ar $5.99 -4 Pasta Salad ar _— rs Honey Roasted Ham ar $5.99 -4 Onion Rings ar ar Curly Fries ar •s Vegetables ar ar Waffle Fries ar •sTurkey ar $6.99 w4 Mashed Potatoes ww.Brown Rice ar ..Glountrg •s Hamburger* $5.99 +►.Tuna w $4.99 Foot Long Dog* $3.99 16 Deserts ,*Chicken Salad ar $6.99 -4Carrot Cake ar $3.99 -a Egg Salad* $4.99 *Cheese Cake ar $3.99 -4 BLT ar $4.99 v Chocolate Cake ar $3.99 ns Cheeseburger* $5.99 .c Black Forest Cake 4r $3.99 s Salami $4.99 Brownie Sunday ar $3.99 Restaurant Sandwiches Served with choice of -4 Ice Cream Sunday Orr $3.99 Lettuce,Tomatoes,Onion,&Peppers 4 Funnel Cake Sunday ar $5.00 Home Style Cooking Bread Choices: White,Wheat,Rye .a Apple Crisp ar Pumpernickel With Whipped Cream $3.50 Hours Cheese Choices: Swiss,Provolone With Ice Cream $4.00 Monday Closed American All Ice Cream is Soft Serve Tue,Wed,Thu 11 am-$pm, Friday 11 am -9 pm Saturday 7 am -9 pm Sunday 7 am-7:30 pm Sat&Sum Breakfast 7-11 am Important Note: We cook to Order: Thoroughly Cooking of Take out Meats,Poultry,Sea Food,Shellfish,or Eggs Menu Reduces the Risk of Food-Born Illnesses. 18 % Gratuities for Parties of 8 or More '6 Appetizers AV Salads Or ' Sea Food Dinners Or VDiabetic & Diet Friendlyir• 1*Mozzarella Sticks aw $4.99 Dinners �s Caesar Salad it -s Rainbow Trout:6 oz.* $10.99 -4 Roasted Turkey Breastir Zr Romaine,Caesar Dressing, Ott Tilapia Fish* $9.99 �a Shrimp Cocktail ar $6.99 Served with Multigrain Stuffing&Salad tic Chicken Strips ar $5.99 Coarse Grated Cheese. -a Cod Dinner:5 oz.* $9.99 $9.99 'a Onion Rings Or $4.99 Regular$6.99 Chicken$7.99 tic Sirloin Beef Stroganoff*5oz.of +a Dipping Sauces*, All Dinner Entrees Served with Salad, Sirloin Beef,Served with Wide Hot Sauce,Horse Radish -4 Chef Salad 4w Whole Loaf Bread,and your Choice of Noodles,in Beef Sour Cream Sauce,and Blue Cheese,Cheese Salad Blend,Romaine,Iceberg,Tomatoes, Two Sides."In House Only" Salad $9.99 Sour Cream,Marinara, Cucumbers,Peppers,Onions,Egg,Turkey, �a Pork Chop*4oz.Baked Pork Chop Honey Mustard,BBQ Ham,Cheese, tis Sides ar Served with Red Potatoes,or Ranch Dressing Dressing&Croutons Mashed Potatoes,Mac &Cheese,Curly Brown Rice,Salad,and the Choice of $7.99 Fries,Waffle Fries,Noodles,Coleslaw, California Blend,or String Beans. Soups or Potato Salad,Fruit Salad,Broccoli,Corn, $9.99 �+a Antipasto Salad ar California Blend,Green Beans. ,a Chicken Piccata#w 4oz.Skinless Cup-$3.50 Bowl-$4.50 Salad Blend,Romaine,Iceberg,Tomatoes, Chicken Breast,'/4 Cup of Sauce, Cucumbers,Peppers,Onions, NO Kids Menu Served with Salad,and Red Potatoes *Corn Chowder# Mozzarella Cheese,Turkey,Ham,Salami, or Noodles,and String Beans ,*Harvest Soup#,4 Chicken Noodle# Dressing&Croutons$7.99 -4 Chicken Nuggets W $3.99 $9.99 ,t Clam Chowder# *4 Hot Dog* $3.99 -a Buttery Pepper&Citrus Fish* (Friday Only) -aHamburger/Cheeseburger* $3.99 Broiled 6oz Boneless White Fish 4 Chili# r*Tossed Green Salad ar _ Served with Salad,Brown Rice,and Choice Salad Blend,Romaine Iceberg, , •4 Pasta&Meatballs a► $3.99-4 Cup Soup&House Salad# Tomatoes of One:California Blend,or Green Beans. $5.50 Cucumbers,Peppers, ti*Kraft Mac&Cheese ar $3.99 $9.99 Onions,Dressing&Croutons 4 Grilled Cheese ar $3.99 -*Grilled Rib Eye Steak*6 oz.Rib Eye CAUTION:SOUPS ARE Regular$6.99 Chicken$7.99 Served with Salad and a Choice of Two: EXTREMELY HOT!! "4 Drinks or Mashed Potatoes,Brown Rice,California Soups Served with ,a Dressings ar Oyster Crackers French,Ranch,Italian,Blue Cheese, Blend Vegetables,or String Beans $9.99 Balsamic Vinegrette - 4 Root Beer Float W $2.50 Sandwiches O Thousand Islands w4 Creamsicle Float ar $2.50 •a Pepsi or Diet Float ar $2.50 '4Diabetic & Diet Friendly*r -a Grilled Chicken Breast ar $6.99 Dinner Entrees -47 Up Float w $2.50 Deserts Pepper -s Honey Roasted Ham ar $5.99 Dr.Pe pp Floatlw $2.50 -4 Sugar Free Jell-O 8oz ar ,4 Foot Lon Hot Do * $3.99 ,a ChocolateNanilla Shake ar $2.75 g g Assorted Flavors,Topped with %Chicken Salad ar $6.99 'a BBQ Ribs* �r Milk/Chocolate Milk ar $1.50 Sugar Free Cool Whip. $2.50 w*Hamburger* $5.99 Half Rack Full Rack -4 Apple Juice w $1.50 ti*Sugar Free Pudding ar -4 Cheeseburger* $5.99 $13.99 * $16.99 3/4 Cup serving of Chocolate or Vanilla ,4 Meat Loaf b $5.99. -4 Rib Eye Steak:12 oz. $14.99 "49 Fountain Drinks Or with Sugar Free Cool Whip. $ 2.50 _ �s Pork Chops $11.99 ti*Sugar Free Low Fat Mousse ar -4 Half Chicken ar p p /4 Cup serving of Chocolate,French �r4 Turkey ar $6.99 $11.99 •*Pepsi a+ti*Diet Pepsi ar 3 ,4 Tuna My $4.99 'a Turkey: 8oz.ar $9.99 �Sprite e arrOrangear Vanilla or Strawberry. $3.50 4 Egg Salad* $4.99 `a Half Pound Meat Loaf ar $9.99 9*Dr.Pepper ar-a 7 Up ar Sugar Free Apple Pie w vs BLT a►w $4.99 'a Mac&Cheese Ar $8.99 v Root Beer Av with Sugar Free Cool Whip $4.00 -,*Salami w $4.99 'a Shepard's Pie ar $7.99 $1.50 ti4 Ice Milk Sunday ar Sandwiches Available with Onion Shepard Pie Sides:House salad, 3/4 Cup Ice Milk Vanilla, Lettuce,Tomato,and Peppers. Whole Loaf Baked Bread."In House Only" Important Note: PP P your Choice of Toppings $4.00 Bread Choices:White,Wheat, *Cooked to Order:Thoroughly Cooking with Brownie $5.00 Rye,Pumpernickel. All Dinner Entrees Served with House Meats,Poultry,Sea Food,Shell Fish,or Cheese Choices:American, Salad,Whole Loaf Bread,and your Choice Eggs Reduces the Risk of Food-Born ► Sugar Free Toppings O Provolone or Swiss. of Two Sides."In House Only" Illness. Carmel,Strawberry,Hot Fudge,Cool Whip, 18%Gratuities Parties of 8 or more Nuts,and a Cherry Town of South Windsor Health Department Telephone(860)644-2511 Extension 248 Temporary Event _ Food Inspection Name of Organization: v one No.: 7 Cell No.: Person-in-charge (PRINT):- J Z Name &Address of Event: L2 a,, r2. U2 Date(s) of Event: Hours of Operation: 6 1 a ------------- -------------- ♦ Hand Washing Setup: S L ed ♦ Waste Water/Garbage Disposal: a4,pA gyp, 'f- ♦ Approved Food&Water Sourc : ♦ Personal Hygiene: +r, ♦ Thermometers/Alcohol Swabs: k'e Qj ♦ Cold Temps(45°F or colder): ♦ Coolers: ♦ Hot Temps(140°F or hotter): yY� ♦ Internal Cooking Temps: CHECK FOOD TEMPERATURES THROUGH-OUT THE DAY*USE YOUR PROBE THERMOMETER ♦ Off-Site Preparation:Approved,Commissary/Licensed Kitchen: 0a�.5 ♦ Cross-Contamination: Utensil Washing: v ♦ Sanitizer/Wiping Cloths: +Pj ♦ Food/Equipment/Single-Use P otection: ♦ Self-Serve Food/Utensils Protected: _ ie-5�> ♦ Proper Construction/Smooth Cleanable Surf ces: ♦ Workers Log (Name,Address, Phone#, Dates &Times Worked) Keep.for 90 days CO RECTIONS DUE IMMEDIATELY ♦ Other: Food Safetv Informatimi on Reverse Side I have read and hereby agree to f Pth e F d Safety i form n list n the reverse side of this form. PERSON IN CHA E ign): Date: ztInspector: Date: 2"`"1 `( 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 aimlication is not a license. Temporary food permits will not exceed a period of I to 5 days. Today's Date Nrime.of Event Wapping Fair______ Dateof Event Sept. 4'— 7th 'Time of Event 914 6 m -10pm956 m — 11p.m. 11 1 r . . - i.. p mn 9/7 10 a.m. —6 Location of Event Evergreen Walk(behind LA Fitness)__ Event Coordinator Paul Petrillo Event Coordinator Address PCBox 486 South Windsor, CT 06074 Event Coordinator Phone# 960-573-6780 Event Coordinator E-Mail Address �wappingfair@aol.cor.q Event Coordinator Phone 4(cell, work& home.)_(C) 860-573-678Q(H) 860-632-1544 Name of Applicant [& r0ef;4. K Name of Applicants Business(please indicate if mobile vendor)_$Aa—X-CLA�Xd I Applicant.s Address le— S-f— &11 Applicants E-Mail Address Applicants Phone#(cell, work&home) OKI a 19 77 4-A 8'0 Set up time P 46 o tAN+ 5k�—L)lp kA "'L v1A e-1 cy IF? Please provide the following: (If any of the following does not apply to you put N/A) I.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.0 1 01)04 A) .o 4krves4 SoOP - boj Uooder - ok,c�4o)kobdel- -Uill* " -- 8 r da j/ % Fr 14 cc C1 T-Opp 0-0011-J'e-1 CIO/ N-b- b-D�'k 2. Describe specifically how frozen, cold, and hot foods will be transported to the event. Z. YU W-DT-3 —:3+@"A-AAer�s rXC)oeA% cle PO-VN-E, %�-rA)er5 1111"Ixle S d 0 3. List all places (name& address) where meats pou ood, see, h, and ice will be purc' hased. �F�T- s-4SQ) VAL 4. List names, phone numbers, addresses, and shifts to be worked of all employees. See attachment#1. + S. Use attachment42 in this packet to sketch a drawing showing the event area and where your operation will be. Wapping Fair will provide layout the week of the fair. 6. Describe the number, location and set up of handwashing facilities to be used by employees. t�" sk44on5 7. Describe how and where utensil/equipment washing will take place. If no facilities are available, describe how alternate steps will be taken. 1404 t5k qqj-N LO US J\�A) -t- OLA 4D" j S. Describe how wastewater will be collected, stored and disposed. Vod,,�,Ko Cc,,,e ,J-- Th' S 1�0 r VK e,,. a4-MJ S 9. Describe the number and location of garbage containers. U Sit('. q-& Wapping Fair will have garbage containers located in area surrounding food areas 10. Describe what heat source will be used to keep hot foods hot (140 degrees and above). CI Not"r' 11. Describe how colds foods will be kept cold (45 degrees and below). JZCe, C>cAtT75 e- d'-eq'475 12. Describe how food temperatures are monitored, cleaned and sanitized, 4o T-5 81- % 13). dill foods be prepared on &? If no, where will foods be purchased? (enclose copy of food license) 0 V-� 16A-SA &LKe d Po-�Lfoe, C3CLkkA S CO rA) 0 tN 00 UX I 16VK9 Cow" TeA, Cv6D NAME OF El i LQYEE PHONE# APDRJR SS SHIFT 1. KCL e n — bdibie. 2. Tohn) p1go- 4, i�db 5. y � &-eAd&, 5 7. 8. vV 10. .. ATTACHMENT #2 CHECKLIST FOR FOOD BOOTH/VENDOR O:EKATORS Metal probe thermometer(0—220 degrees F range) 1� Thermometers for all refrigerators _-4/--coolers and ice packs (if ice is to be used for cooling of foods, where is water to be drained) Plastic wrap/Aluminum foil V _Y Extra utensils: tongs, spatulas, spoors, and knives Water source t� Buckets/tubs for washing, rinsing, sanitizing food equipment Bleach for sanitizing, test strips for checking V Waste water disposal container V _Container(s) for grease collection N® k�)Q, S 9 ek, Crt6 G'IFU— t—� _ I/ dean wiping cloths and a container to store them in FCL"' CjL_ ePs 4 r/ Garbage containers and Mastic lags R • Fats/hair restraints Crates, shelves to sure food off of the ground Gloves foi-food handling �_.Rand washing station 5 Town of South Windsor Health Department Telephone(860) 644-2511 Extension 248 Temporary Event — Food Inspection Name of Organization:I +JZ COCK(NjkS TIAVI L-t a�honC o.:(�32-►s`�fy Cell S-7 3- Person-in-charge (PRINT): Cam% C R A Name &Address of Eyen pa, Date(s)of Event: 9!mot Hours of Operation: C=p ♦ Hand Washing Setup: S-i T up nr f> ♦ Waste Water/Garbage Disposal: L-Ms,-W uipot-c 2 70 ♦ Approved Food&Water Source: � �..� R£s � � Pe��•,�y ♦ Personal Hygiene: I<- .♦ Thermometers/Alcohol Swabs: ♦ Cold Temps(450F or colder): Est£e- c�fL ♦ Coolers: ae.► S , 7,5-_ ♦ Hot Temps(140°F or hotter): �� o�gs'L�`i� *►� �^^-� o� „�sprc ♦ Internal Cooldng Temps: N-C�t CHECK FOOD TEMPERATURES THROUGH-OUT THE DAY*USE YOUR PROBE THERMOMETER ♦ Off-Site Preparation: Approved Commissary/Licensed Kitchen:WCOAae'%�> -AT- ,UeW 94 J ♦ Cross-Contamination:C-�c-te_---,i 1 Utensil Washing: Rcsr-,vw I(�j p ew t ♦ Sanitizer/Wiping Cloths: S �rcz ►a�Pn... a����� , r4 ♦ Food/Equipment/Single-Use Protection:_A-- StsQ.N C'-Wurt-q ♦ Self-Serve Food/Utensils Protected: ♦ Proper Construction/Smooth Cleanable Surfaces: o�c ♦ Workers Log (Name,Address, Phone#, Dates &Times Worked) Keep.for 90 days_ A Po .A,%,cj CORRECTIONS DUE IMMEDIATELY ♦ Other: Food Safety Information verse Side I have read and hereby agree t .follow the Food Safety for n listed on the reverse side of this orm. PERSON IN CHARGE (Sign): Inspector: l Date: �% c� VENDOR APPLICATION FOR TEMPORARY FOOD EVENT The VENDOR of each temporary food event must complete this application and must be filed 14 da ys ays 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 ai)plication is not a license. Temporary food permits will not exceed a period of I to 5 days, Today's Date Name of Event Wappino, Fair C) Date of Event —Sept. 0'— 7th Tilrne of Event 9A 6 p.M.-110 9/5 6 p.m. — 91'V�- 110 a.m. -111 P.m.; 9/7 10 a.m. —6 p.m, Location of Event-Evergreen Walk(behind LA Fitness) EventCoordinator Paul Petrillo Event Coordinator Address POBox 486 South Windsor, CT 06074 Event Coordinator Phone# 860-573-6780 Event Coordinator E-Mail Address wappingfa.ir(@,aol.com Event Coordinator Phone 4(cell, work& home)_(C) 860-*57376780(II) 860-632-1544 Name of Applicant 6IN 0" WN Name of Applicants Business(please indicate if mobile vendor) Applicants Address Applicants E-Mail Address k Pf�\"well V) Applicants Phone 4 (cell, work& home) OD14 �btIT4,15 Set up time Please provide the following: (If any of the following, does not apply to you put N/A) Uist 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. ?"Tft- CM(" 2. Describe specifically how frozen, cold, and hot foods will be transported to the event. aw M'O V T:7� 1*09 PVT 11V S O-eAR ewf� )N&P- I List all places (dame&address) where meats, poultry, seafood, shellfish, and ice will be purchased. ��ToNw I pEfVT FA 5100 4. List names, phone numbers addresses, and shims to be worked of all mployeesQ attachment #1. �OV �� IN�� G4-lib 5. Use attachment 42 in this packet to sketch a drawing showing the event area and where your operation will be. Wapping Fair will provide layout the week of the fair. 6. Describe the number, location and set up of handwashing facilities to be used by employees. bjl✓ "-O,\rS 6WC- '91Uff>O '* jtS RC-AR WD AN OTM&P- ONC- LOAD e0v 7. Describe how and where utensil/equipment washing,will take place. If no facilities are available, describe how alternate steps will be taken. 'N P-Y-T TOWPN9PP► ONr T Na �l1i-ac-S �v't�lS t PAC I (�L USA 6 N � &Af W P LAC AMJ i,t, i f?R &� V S Wcr e UCArt U N OOLOC. S. Describe how wastewater will be collected, stored and disposed. 061f tu�IL WILL, 6F CIOUIPMP Sw T*1 Tvelx 6UCKGT Uj RtN 37 13 tv U �P Ne ?� 10 �"U- AND 6ANC—Wy— j �& "L)AW-1 'ro &1*0560. 9. Describe the number and location of garbage containers. Wapping Fair will have garbage containers located in area surrounding food areas 10. Describe what heat source will be used to keep hot foods hot (140 degrees and above). 1'�6 "f ge""Lu Tt Vz" W&T P"D twt-' Pr" 11. Describe how colds foods will be kept cold(45 degrees and below). N M7�15C-F" (2-, � Pftt, TYAC, 12. Describe how food temperatures are monitored, cleaned and sanitized. fiWMOKUX—P To KON'I*f- "W-4r'TUA�S , PO D �y NOW C(IC-AN P1 PrLL TIME. 13. Will foods be prepared on site? If no, where will foods be purchased? (enclose copy of food license) h10 FSVp ?WA4-AC-- A-r WE (k)G- Ibb A_J-- -7"6.9 1-0 A ONT NAME OF EMPLOYEE PHONE## ADDRESS SHIFT 1. C AO,ft�� 6L 2. 4. 5. 6. 7. 8. 9. 10. ATTACHM N'r #2 CHECKLIST FOR MOOD BOOTHNENDOR 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/tugs 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 4 Garbage containers and plastic lags Fats/hair restraints Crates, shelves to store food off of the ground Calcyves for ford handling Hand washing station 5 TM (formerly National Assessment Institute, Inc.) j�j�9.�r�.za�,r. t��✓�t��vr e�rtc�'a�iarz CHATOU1 LORSIN CERTIFIED PROFESSIONAL FOOD MANAGERTM uIaaall" &4 kvaiW /Wrir4sed Training Provided By American Food Safety Institute g00-723 3873 Anthony W. Mitchell, Ph.D. Certificate Issued: 2/27800 TCSScode: 62�8�?3 IO©i VENDOR APPLICATION AND GUIDELINES FOR TEMPORARY FOOD SERVICE EVENTS ArsweY ®- Fro vi 6 t S,tea.7m fade , M � �•n 71�1 I C00 e� hand`' • V� fry ey- I CVA i frr�r4cv, �. 1 � i �w wou< . t"r evif-Newl I�0- t ye 5 o m "lY deaf w < e cY vt`M i s c y�e k, 6 u 04 9 ! `� we � so have v� e cevA r,'c e ©A 3 c, We (n9r li trams��Y�(�e �avleet i�► Co6!'e1 ` fv "{Uoe We wi�l }-J $eve�'a U�ev.�a' S t (� �Y'!h ev►Qi�4hGhg '�O G�8 G.�FR$Gj,°�J rlS't � SA •0e (7a �'n� ��Y�� � c�InSi� ba"C�- LfL Y'esic'u C'4if C l J OCi3ie raAZr cod'a"t. A)O� 5 tale s,��l ei�a� tkel%nbl^Ielocs: ol4v, eac( Useol by c6hel Frey rak, B < t ®�r Seb rae C{ We USepQ Gl'ep-r " c,"A ftl em r t,•�c91e ,fOIAA ago l�,e <<nCcJ ov�pv- ��OF f6cf "Keep ;�, gfeo.m (cVe-y I 'qa"F) - Page 1 of 1 Devito, Robert From: DeVito, Robert Sent: Wednesday,August 13, 2008 11:07 AM To: 'nipaporn_klang@yahoo.com' Cc: 'WappingFair@aol.com' Subject: Wapping Fair Hello, I have received and reviewed your application for you to offer food for the upcoming Wapping Fair here in South Windsor, CT. Please take the time and answer the following concerns I have: 1. Please provide a map showing how you will set up your area.This map must show coolers, tables, hand washing areas, etc. 2. Am I correct when I say you will only be serving chicken dishes? 3. How will you be transporting your potentially hazardous foods?Will the chicken be frozen or thawed?Will rice be cooked at the fair? 4. i do not understand how you will wash equipment.You cannot use the cooler that will be used for hand washing. I would recommend that you bring several utensils so you can change them as needed (put them in a container when they are dirty and bring them back to restaurant at the end of the day)or bring enough pans to do washing rinsing and sanitizing. If you choose to wash at the fair,where will your waste water be emptied? I do not think you will be able to collect and transport all the waste water generated (steam table, ware washing, hand washing)daily and return it to your restaurant. I may be wrong, but please explain. 5. Your themometers need to be sanitized after each use. I recommend purchasing alcohol prep pads. 6. Please remember that the steam tables you,propose to use are for keeping foods hot not for cooking.The foods must be hot before they are placed in the steams tables. How do you plan on cooking the chicken? Please call me at 860-644-2511, extension 248 if you have any questions. Thanks Bob 8/13/2008 Wapping pair-Inbox-Yahoo! Mail Page 1 of 2 Yahoo! My Yahoo! Mail More Make Yl My Home Page Hi, nipaporn_klang Sign Out All-New Mail Help "VAM4001e MAIL ! Search —_ -- — WEB SEARCH classic i Convenient and secure Online Banking with Free Checking e •Online Statements •BIIIPay •Balance Alerts A �w�e�aER Mail Contacts Calendar Notepad_ What's New? Mobile Mail _bons Check Main; Compose _ Search Mail , Search the Web' IMiami, Florida Previous I Next I Back to Messages Mark as Unread I Print Top hotel deals! Delete Rep{y Forward, Spam Move... r Folders [Add - Edit] i Wapping Fair Wednesday,August 13,2008 11:06 AM Inbox(35) _� From: "DeVito,Robert"<Robert.DeV!to@southwindsor.org> Drafts To: nipaporn_kiang@yahoo.com Sent Cc: WappingFair@aol.com Spam(83) [Empty] Trash [Empty] I Hello, I have received and reviewed your-application for you to offer food for the Search Shortcuts upcoming Wapping Fair here in South Windsor, CT. Please take the time and My Photos answer the following concerns I have: My Attachments i _ 1. Please provide a map showing how you will set up your-area.This map ADVERTISEMENT must show coolers,tables, hand washing areas,etc. 2. Am I correctwhen I say you will only be serving chicken dishes? 3. How will you be transporting your potentially hazardous foods?Will the chicken be-frozen or thawed?Will rice be cooked at the fair? The 4. 1 do not understand how you will wash equipment. You cannot use the shockingcooler that will be used for hand washing. 1 would recommend that you ' bringseveral utensils so you can change them as needed y g (put them in tay so slim -a container when they-are dirty and tiring them-back-to restaurant at the v►ru.rrj end of the day)or bring enough pans to do washing rinsing and sanitizing. If you choose to wash at the fair,where will youl=waste water - be emptied?I do not think you will be able to collect and transport all the waste water generated (steam table,ware washing, hand washing) daily and return it to your restaurant.I may be wrong,but please explain. 5. Your themometers need to be sanitized after each use.I recommend purchasing-alcohol prep pads. & Please remember that the steam tables you propose to use are for keeping foods hot not for cooking. The foods must be hot before they are placed in the steams tables. How do you plan on cooking the chicken? http://-us.mc521.mail.yahoo.com/mc/showMessage?fld=lnbox&sort=date&ordor—down&st... 8/13/2008 Town of South Windsor Health Department Telephone(860) 644-2511 Extension 248 Temporary Event — Food Inspection Name of Organization: T Phone No.: Cell No.: Person-in-charge (PRINT): Name &Address of Event: Date(s) of Event: Hours of Operation: l�l ♦ Hand Washing Setup: 'p ♦ Waste Water/Garbage Disposal: b/L ♦ Approved Food&Water Source: Personal Hygiene: ♦ Thermometers/Alcohol Swabs: ♦ Cold Temps(45°F or colder): ♦ Coolers: ♦ Hot Temps(140°F or hotter): ♦ Internal Cooldng Temps: CHECK FOOD TEMPERATURES THROUGH-OUT THE DAY*USE YOUR PROBE THERMOMETER ♦ Off-Site Preparation:Approved Commissary/Licensed Kitchen: A)a 1- iQ ♦ Cross-Contamination: I I Utensil Washing: -- ed i i M ♦ Sanitizer/Wiping Cloths,: ♦ Food/Equipment/Single-Use Protection: ♦ Self-Serve Food/Utensils Protected: ♦ Proper Construction/Smooth Cleanable Surfaces: ♦ Workers Log (Name,Address, Phone#, Dates &Times Worked) Keep.for 90 days ♦ Other: CORRECTIONS DUE IM DIATELY '� � pip (o Food Safety Information on Reverse Side I have read and hereby agree to follow the Food Safety Information listed on the reverse side of this form. PERSON IN CHARGE (Sign): Date: Inspector: Date: 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 _08/18/2008 Name of Event Wapping Fair Date of Event Sept. 4a'—7th Time of Event 9/4_6 p.m.-10 p.m.;'9/5 b p.m.— 11 p.m. 9/6; 10 a.m. -1 l p.m.; 9/7 10 a.m.—6 p.m. Location of Event Evergreen Walk(behind LA Fitness) Event Coordinator Paul Petrillo Event Coordinator Address PO Box 486 South Windsor, CT 06074 Event Coordinator Phone# 860-573-6780 Event Coordinator E-Mail Address wappingfair@aol.com Event Coordinator Phone#(cell, work&home)_(C)860-573-6780(H) 860-632-1544 Name of Applicant Kelly A. Burns Name of Applicants Business (please indicate if mobile vendor)_South Windsor Jaycees Applicants Address 962 South Main Street#5 Plantsville, CT 06479 Applicants E-Mail Address kab@avhlaw.com Applicants Phone#(cell,work&home)_203-824-3320 (c)/860-275-8109 (w) Set up time 2 hours prior to fair hours of operation each day Please provide the following: (If any of the following does not apply to you put N/A) CTDOCS:25986.1 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. • Hamburgers • Cheeseburgers s • Hot Dogs • Chili & Pin tPr llv Sand�e • Pickles • Potato Chips • Bottled Soda • Bottled Water • Juice Boxes 2. Describe specifically how frozen, cold, and hot foods will be transported to the event. Cold foods(e.g. hamburger patties,hot dogs and cheese)will be delivered by an outside vendor in their refrigerated truck. Items will them by placed directly into the on site refrigerator/freezer. No hot foods will be transported to the event. All foods will be cooked/prepared on-site. 3. List all places(name&address)where meats,poultry, seafood, shellfish, and ice will be purchased. Ice—Dee Zee Ice, 350 Chapel Road, South Windsor, CT, 860-528-3500 Hot dogs,hamburgers, veggie burgers-Vistar Foods Windsor, CT 06095 4. List names,phone numbers, addresses, and shifts to be worked of all employees. See attachment#1. The South Windsor Jaycees will employ a volunteer sign in sheet to track all volunteers who work at the South Windsor Jaycee food booth. 5. Use attachment#2 in this packet to sketch a drawing showing the event area and where your operation will be. Wapping Fair will provide layout the week of the fair. 6. Describe the number, location and set up of handwashing facilities to be used by employees. The Wapping Fair will provide hand washing station in the area surrounding the food area. CTDOCS:25986.1 2 7. Describe how and where utensil/equipment washing will take place. If no facilities are available, describe how alternate steps will be taken. Utensil/equipment washing will not take place on-site, rather the food booth will utilize several sets of utensils throughout the day. An individual set will be used for no longer than two hours (or earlier if it becomes soiled)before it is replaced with a clean set. At the days end all utensil sets will be removed from the premises and appropriately cleaned and disinfected. 8. Describe how wastewater will be collected, stored and disposed. The food booth will not generate waste water. 9. Describe the number and location of garbage containers. Wapping Fair will have garbage containers located in area surrounding food areas 10. Describe what heat source will be used to keep hot foods hot(140 degrees and above). Food will be cooked to-order on a 6 foot propane powered grill. 11. Describe how colds foods will be kept cold(45 degrees and below). Perishable foods will be stored in a freezer prior to cooking. 12. Describe how food temperatures are monitored, cleaned and sanitized. The food booth will maintain several metal probe food thermometers to monitor the temperature of cooked items. An individual thermometer will be used for no longer than two hours (or earlier if it becomes soiled)before it is replaced with a one. At the days end all thermometers will be removed from the premises and appropriately cleaned and disinfected. 13. Will foods be prepared on site? If no, where will foods be purchased? (enclose copy of food license) All foods will be prepared on site,with the exception of pre-packaged drinks and snacks(e.g. potato chips and soda). CTDOCS:25986.1 3 NAME OF EMPLOYEE PHONE# ADDRESS SHIFT 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. ATTACHMENT #2 CHECKLIST FOR FOOD BOOTH/VENDOR OPERATORS Metal probe thermometer(0—220 degrees F range) CTDOCS:25986.1 4 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 CTDOCS:25986.1 5 VENDOR APPLICATION AND GUIDELINES FOR TEMPORARY FOOD SERVICE EVENTS H:\ppetrillo\Wapping Fair\Work\TempomryFoodCoordimtorApplication2007\TempomryFoodVendorApplication2007.doe CTDOCS:25986.1 Town of South Windsor Health Department Telephone(860) 644-2511 Extension 248 Temporary Event Food Inspection Name of Organization: S WHS C r e�c N «J, 9 � Phone No.: Cc32- 154y Cell No.:_Nl�)S'73- Q.,7% - Person-in-charge (PRINT):_. Name &Address of Event: SAP Nf\-, .ems rs ve s� W Date(s)of Event: Hours of Operation: C.;,.- I c")j . ♦ Hand Washing Setup: ' , ♦ Waste Water/Garbage Disposal: ♦ Approved Food&Water Source: C.*-c� NrA-e� ♦ Personal Hygiene: A-r�.--N"b A or- a.&s ♦ Thermometers/Alcohol Swabs: s�.nv ♦ Cold Temps(45°F or colder): use -o/ c.S Fo-r- .ski ♦ Coolers: o�s S, Fo c 1b e,K S, ♦ Hot Temps(140°F or hotter): C p oil Est Fw r toL C. s ♦ Internal Cooking Temps: CHECK FOOD TEMPERATURES THROUGH-OUT THE DAY*USE YOUR PROBE THERMOMETER ♦ Off-Site Preparation:Approved Commissary/ Licensed Kitchen: ♦ Cross-Contamination: ►.,t, e--- ' i -re 3s A,5- vjzs� Utensil Washing: -m 84- cc.£c--V-h� hT L1c ♦ Sanitizer/Wiping Cloths: C -w-ile,-f-t- c.��ast cic.�� ♦ Food/Equipment/Single-Use Protection: a w- ♦ Self-Serve Food/Utensils Protected: c_-5c ♦ Proper Construction/Smooth Cleanable Surfaces: _ ni,- ♦ Workers Log (Name,Address, Phone#, Dates &Times Worked) Keep-for 90 days CORRECTIONS DUE IMMEDIATELY ♦ Other: Food Safety Information on Reverse Side I have read and hereby a ee to follow the Food Safety Information listed on the reverse si a of thissfform. PERSON IN CHALE ign): Date: UO Inspector: Date: 9/4y 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 apnlication is not a license. Temporary food permits will not exceed a period of 1 to 5 days. Today's Date 8/21/08 Name of Event Wapping Fair Date of Event Sept. 4 h—7th Time of Event 9/4 6 p.m.-10 p.m.; 9/5 6 p.m.— 11 p.m. 9/6; 10 a.m.-11 p.m.; 9/710 a.m.—6 p.m. Location of Event Evergreen Walk(behind LA Fitness) Event Coordinator Paul Petrillo Event Coordinator Address PO Box 486 South Windsor, CT 06074 Event Coordinator Phone# 860-573-6780 Event Coordinator E-Mail Address wappingfair@aol.com Event Coordinator Phone#(cell,work&home)_(C) 860-573-6780(H) 860-632-1544 Name of Applicant Amanda Martin Name of Applicants Business(please indicate if mobile vendor)_SWHS Cheerleading Applicants Address_100 Wells St.Apt. 514,Hartford, CT 06103 Applicants E-Mail Address amandalmartin@gmail.com Applicants Phone#(cell,work&home) (860)212-1225 Set up time_1/2 hour before the fair opens each day 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 14 days prior to the event. Nachos: Tortilla Chips,Nacho Cheese, (�soXam,ja Knos Bottled Water Cans of Soda 2. Describe specifically how frozen, cold, and hot foods will be transported to the event. Tortilla chips, nacho cheese, salsa and jalapenos are non-perishable and do not require special transportation. Sour cream will be transported and stored in a cooler with ice. Nacho cheese sauc3e will be heated on site with a crock pot. Should the salsa and/or jalapenos need to be refrigerated after opening they will be stored in a cooler with ice as well. 3. List all places(name&address)where meats, poultry, seafood, shellfish, and ice will be purchased. BJ's Wholesale Club, Manchester, CT. 4. List names, phone numbers, addresses, and shifts to be worked of all employees. See attachment#1. See attachment. 5. Use attachment#2 in this packet to sketch a drawing showing the event area and where your operation will be. Wapping Fair will provide layout the week of the fair. 6. Describe the number, location and set up of handwashing facilities to be used by employees. We will have one hand washing station within our booth. The set up will consist of a container of clean water with a spout that can be opened to allow continuous flow of water. The water will be deposited into a bucket under the spout. We will use antibacterial soap and also have hand sanitizer as well as food service gloves. 2 7. Describe how and where utensil/equipment washing will take place. If no facilities are available, describe how alternate steps will be taken. The equipment will need to go home at the end of each night for cleaning. This equipment only includes a ladle and crockpot for the cheese. We will be using disposable spoons for the salsa, sour cream, and jalapenos. 8. Describe how wastewater will be collected, stored and disposed. The only waste water will be from hand washing, and will be brought home at the end of each night and disposed of. 9. Describe the number and location of garbage containers. Wapping Fair will have garbage containers located in area surrounding food areas 10. Describe what heat source will be used to keep hot foods hot(140 degrees and above). Crock Pot. 11. Describe how colds foods will be kept cold(45 degrees and below). Cooler with ice. 12. Describe how food temperatures are monitored, cleaned and sanitized. Pasteurized cheese sauce doesn't need to be temperature tested for health reasons, it's precooked and can be eaten cold. If it is requested,the temperatures can be recorded throughout the day. 13. Will foods be prepared on site?If no, where will foods be purchased? (enclose copy of food license) Everything is prepackaged, the only preparation is heating the cheese and putting the chips and cheese in a container for the customer. 3 Name Phone Address Shift Conrath,Renee 644-8036 South Windsor, CT Sat. 6:00-9:30, Sun. 3:30-6:00 Fox,Amanda 649-6701 South Windsor, CT Sat. 7:30-11:00 Sun. 10:00-2:30 Hall,Jasmine 528-3327 South Windsor, CT Thurs. 6:00-9:00, Sat. 5:30-9:30 Hankard,Moll 290-8326 South Windsor, CT Sun. 10:00-6:00 Jay,Becky 282-0860 South Windsor, CT Sun. 10:00-6:00 Kelly,Brighid 644-8145 South Windsor, CT Fri. 6:00-9:30, Sat. 1:30-5:30 Kelly, Caitlin 644-8145 South Windsor, CT Fri. 6:00-9:30, Sat. 1:30-5:30 Marcotte,Nicoiette 289-0454 South Windsor, CT Fri. 7:30-11:00, Sun. 10:00-1:30 Michelsen,Kelsey 432-2487 South Windsor, CT Fri. 6:00-9:00, Sun. 1:30-5:30 Michelsen, Tessa 432-2487 South Windsor, CT Fri. 6:00-9:00, Sun. 1:30-5:30 Pavel,Bella 282-9174 South Windsor,CT Fri. 7:00-10:00, Sat. 5:30-9:30 Perleoni,Kristina 436-4095 South Windsor, CT Thurs. 6:00-9:30, Sun. 3:30-6:00 Policarpio,Catelyn 290-9035 South Windsor, CT Sat. 1:30-5:30, Sun. 1:30-5:30 Prince,Janelle 645-9470 South Windsor, CT Thurs. 6:00-9:00, Sat. 5:30-9:30 Santos,Liz 644-8829 South Windsor,CT Sat. 7:30-11:00, Sun. 10:00-1:30 Santos,Pavi 648-2937 South Windsor, CT Sat. 7:30-11:00, Sun. 10:00-1:30 Woods,Kayla 648-0389 South Windsor, CT Thurs. 6:00-9:00, Sat. 10:00-1:00 Martin,Amanda 212-1225 Hartford,CT Thurs.-Sun. Bu anski,Mike 648-0389 South Windsor, CT Thurs. Kelly, Coleen 644-8145 South Windsor, CT Fri. Lanier,Carolann 290-9035 South Windsor,CT Sat. Conrath,Karen 644-8036 South Windsor, CT Sun. ATTACHMENT #2 CHECKLIST FOR FOOD BOOTMVENDOR OPERATORS 4 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 Town of South Windsor Health Department Telephone(860) 644-2511 Extension 248 Temporary Event — Food Inspection Name of Organization: Cb>iL L ;v Phone No.: Cell No.: o-2,SS Person-in-charge (PRINT): 1�H, ,,4 _2c Name &Address of Event: w Fa.2 e_'=D Date(s)of Event: y Hours of Operation. ♦ Hand Washing Setup: ate, i ♦ Waste Water/Garbage Disposal: C4 ♦ Approved Food&Water Source: ♦ Personal Hygiene: ♦ Therm::2ers cohol Swabs: ♦ Cold Temps(45°F or colder): V0 ♦ Coolers: ♦ Hot Temps(140°F or hotter): ♦ Internal Cooldng Temps: CHECK FOOD TEMPERATURES THROUGH-OUT THE DAY*USE YOUR PROBE THERMOMETER ♦ Off-Site Preparation:Approved Commissary/ Licensed Kitchen: ♦ Cross-Contamination: Utensil Washing: ♦ Sanitizer/Wiping Cloths: U T7A it I Ts — ju6 ♦ Food/Equipment/Single-Use Protection:_ ♦ Self-Serve Food/Utensils Protected: ♦ Proper Construction/Smooth Cleanable Surfaces: 5TE ♦ Workers Log (Name,Address, Phone#, Dates &Times Worked) Keep for 90 days ORRECTIONS DUE I MEDIAT Y ♦ Other: S09Z b Itaki _ — OJ Food Safety Information on Reverse Side I have read and hereby agree to follow the Food 10fety Information listed on the reverse side of his for . PERSON IN CHARGE (Sign): Date: Inspector: Date: VENDOR APPLICATION FOR TEmPoRARY FOOD EVENT The VENDOR of each temporary food event must complete this application and must be filed 1.4 days prior to the opening evert. This application must be submitted to the Town of South Windsor Health Department, 1540 Sullivan Avenue, South Windsor,CT 06074. This apDiication is not a license. Temporary food permits will not exceed a period of I to 5 days. Toay's Date [ Name of Event Wapping Fair-- Date of Event Sept. 4t"-7th Time of Event 9/4 lr.ii�. tv aF,i1i,, ,.'1✓ W p.�n. 1 L t.�7.Id 1. :7/t.'y iil Cl.11. "11 �.jl.., 9/7 10 a.m. -6 p.m. Location of Event Evergreen Walk(behind LA Fitness) Event Coordinator Paul Petrillo Event Coordinator Address PO Box 486 South Windsor, CT 06074 Event Coordinator Phone# 860-573-6780 Event Coordinator E-Mail Address ' wappingfair@aol.com Event Coordinator Phone# (cell, work& home)_(C) 860-573-6780(IT) 860-632-1544 Name of ApplicantD Name of Applicants Business (.please indicate if mobile vendor)' Applicants Address Applicants E-Mail Address hoo Applicants Phone#(cell, work&home) �-(� o CLo a- S- Set up time_ 4.00 Please provide the following. (If any of the following does not apply to you put N/A) I.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. 1 F1',111.014 �S�R 0�nKv�i 2. Describe specifically how frozen, cold, and hot foods will be transported to the event. 1:7 c e Cree-ti I'--re e Can /1 4-h 6 3. List all places (name& address) where meats, poultry, seafood, shellfish, and ice will be purchased. 4. List names, phone numbers, addresses, and shifts to be worked of all employees. See attachment #1. Pate- � 5. Use attachment#2 in this packet to sketch a drawing showing the event area and where your operation will be. Wapping Fair will provide layout the week of the fair. P f 5� 6. Describe the number, location and set up of handwashing facilities to be used by employees. bee ' 7. Describe.how and where utensil/equipment washing will take place. If no facilities are available, describe how alternate steps will be taken. 4-1 2 S. Describe how wastewater will be collected, stored and disposed. i I ti bet ckek co,4 J-o 6 e 14a 0 9. Describe the number and location of garbage containers. ';z C-C/l/. on e- Wapping Fair will have garbage containers located in area surrounding food areas 10. Describe what heat source will be used tokeep hot foods hot (140 degrees and above). I .11. Describe how colds foods will be kept cold (45 degrees and below). �lr C-V—' Z -e &,-- 12. Describe how food temperatures are monitored, cleaned and sanitized. AJ-IAI- 1 13. Will foods be prepared on site? If no, where will foods be purchased? (enclose copy of food license) NAME OF EIVIPLCYEE PHONE# ADDRESS SFUFT .1. -J o5e 2. Fa 4- �3 �f 3. /►� Gf rc -2)e 144 arcv s �e �1it aL►'�v � �/ 4, t,�Cr a rt 5. 6. 7. 8. 0. 10. 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 —_ i Extra utensils: tongs, spatulas, spoons, and knives Water source f'i%l� r i�� < c Gv o 1 erg 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 4 .,-� Crarbage containers and plastic bags —_� Fats/flair restraints Crates, shelves to stare food off of the ground Gloves for f,)ad handling —.Hand washing station Alew wash. Ise- VIP? 0 5 Town of South Windsor Health Department Telephone(860)644-2511 Extension 248 Temporary Event — Food Inspection g a� (a%F�-95Z3 Name of Organization: C l c0S Phone one No.: Cell No.: Person-in-charge (PRINT): Anst�e,-A 31tSL Name &Address of Event gyp, �w �e , e-VZV_6' t� sf Date(s)of Event: 9yi$� Hours of Operation: Ur�N-- ♦ Hand Washing Setup: Sc- ,--A CV C.. %F'c.S, ;e 7br&_�7 ♦ Waste Water/Garbage Disposal: 7b-3 ¢��S s�S ��"�-ro c� G •(�L� ♦ Approved Food&Water Source: A—— ` ♦ Personal Hygiene: ♦ Thermometers/Alcohol Swabs: -1 G-,j -s "1-t ^JS ♦ Cold Temps(45°F or colder): (2auc-C e- a s„1f ♦ Coolers: ♦ Hot Temps(140°F or hotter): '�^� � � N y o3c.rL� ♦ Internal Cooldng Temps: wB ` n�S CHECK FOOD TEMPERATURES THROUGH-OUT THE DAY*USE YOUR PROBE THERMOMETER ♦ Off-Site Preparation:Approved Commissary/Licensed Kitchen: ♦ Cross-Contamination: Utensil Washing: A,� ♦ Sanitizer/Wiping Cloths: ♦ Food/Equipment/Single-Use Protection: ♦ Self-Serve Food/Utensils Protected: Ole— ♦ Proper Construction/Smooth Cleanable Surfaces: ♦ Workers Log (Name,Address, Phone#, Dates &Times Worked) Keep.for 90 days An�2 CORRECTIONS DUE IMMEDIATELY COL, To 3� ,� a►� ♦ Other: tzs"•�''�.�°„�" Food Safety Information on Reverse Side 1 have read and hereby ree to follow the Food Safety Information listed on the reverse side oft is form. PERSON IN CHARGE (Sign): Date: ')/1-1 ��� Inspector: Date: / �� AA w VENDOR APPLICATION FOR TEMPORARY FOOD EVENT b 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 '�L�- 9 Name of Event W i l-*" Date of Event S i �� 6 7 Time of Event �+7Gtvr,, — 6-11 r^ 6 � lrp� 7- fa Location of Event l a-14 ad b e_A 1, )—A 1', �Event Coordinator R_t4,) T�'�M `t e J C S1 Event Coordinator Address Event Coordinator Phone# 3 73— 6 760 Event Coordinator E-Mail Address Iti5 /v Event Coordinator Phone#(cell,work&home) S 73 0 67v Name of Applicant J v Name of Applicants Business (please indicate if mobile vendor)CI t)AJS �i 1/� Applicants Address e-ffS 6)cf-C 4Jl 4Xwyr 0607 Gam` Applicants E-Mail Address Ca nv) )?�N. N s cd/'-) Applicants Phone#(cell, work&home) 06D-91 V'20 6 Set up time Thvv I 'oQ Please provide the following: (If any of the following does not apply to you put N/A) 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. J Pr� / �f� S, t; Al d AIC LCe C1-egM, P&i ��.: Moz zu� U c� S�c S, Piled ' ►Z2c_S�f CC'S j V J14 00414 alld (La.t.e j V 2 va1-4L?c S 2 2. Describe specifically how frozen, cold, and hot foods will be transported to the event. _ VrfOlaeAl e4r �l �S` �-k - Tv 9 6L � be low 3O'F'A t I,e Moe z s �zoQ �ne� 1CCUc'" iAV) / ct� eur fC { 6S(��,c(Az � �`fi�e- Ic�C`t�+ `_dn E'lin�dQLCt-�i�tiC<S,�k IaaJCJ�— lt�S�o� '61kC c,,,',IcP ix-NI?_M4A wTesr The wi 1( b-C j>1sLLeJ iti 4-t-C 1 04-- Q11z4s 1( be eov1 W & ti S�c� //�� CyQN, NO PlZ2c.5 w {S .���owQuQ �O Pttti•►,M M�►>L �.ry , .�J _LNcr Cook j r n vC i,rp C C - W e ''Oe P��PVjr tC/4" Mtr�wu/'�L S e4 k e�' a,, ♦ �� UJ Lei+t► !ce. 3. List all places(name&address)where meats,p Cry, s)>feod, si sh, and ice will a L)urchased. ice k"J( Cvt�- '1%m oq_r' c �� ��.� �- q6S t3�c��t� I't oe�'1 m Coy — t v p 44Q Pe e(b A/,✓t — 0, R,1-4 Cl Vt 4. List names,phone nuvbers, addresses, and shifts to be worked of all employees. See attachment#1. .Mtc� � l�or•, � SPA >41-r.��- (,,p,bZ C,,-,Me ()I Aar� 0 e- Mcckt,J Jo6PS(if01 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 byemployees. '� n �ws�ll�� l®c��io`ti �teCx - Coo�tc2� areL rA, Ga CC90 f er cti t�'� htJ co a p Q 4 P-ee - c✓� �tr- dfet( -19- Vt+O a he e m Cis c4-46S OL-CL 7. Describe how and where utensil/equipment washing will take place. If no facilities are available, , describe how alternate steps will be taken. Ak -,f e. ��� {�`►' c �jk2 6e 6h,ws� � 4 Av b<- wks�e� `�kQi� w�1I �t a &cLj 4 c,,. eG, d�S P tivc Qa', 8. Describe how wastewater will be collected stored and disposed. /�v Cwer(.S tvJr �•�C ( � .�/Le./v�aat/'e /�iti ni AIer� C u`- �e oco G 4- O�� YGS—6),.ALa--..r � c �{L'I d o p'a s eel S 9. Describe the number and location of garbage containers. (� 1 _ �— V'CC�C —A` �l`� 8M COoO�i� R6C'C� 10. Describe what heat source will be used to keep hot foods hot(140 degrees and above). Fr JUjje1- he-'+S Ado_+.O a ve 3( 0 0VeN �,eLJs Pt zacc ^--e 11. Describe how colds foods will be kept cold(45 degrees and below). w� �►�( �� a �r c t Z cr }-�, ize cP �vz�ti i F-c.�.� I�e���,r 3 4z 2,0',> pads. . �,�s J-�-QetuCe C&Ij 12. Describe how food temperatures are monitored, cleaned and sanitized . r Tic' C'-C�mod` p�/0.�-r- kl---t VCAV S<#-I'� j h' -1'I�e�� �,•{-cam a,4 {uep e,. +C er toq, rVI Z. j 5ef, afv,�w��"� �a�C�S 1�0 t,i� - �1�1'(�f�O�vS�til�i`l1-Vs 13.Will foods be prepared on site??f no,where will foods be purchased? (enclose copy of food license) S`P �1( Pvads .�J� b� ��t gut ui- �6s 6�cu� M s. U, �T 3 NAME OF EMPLOYEE PHONE# ADDRESS SHIFT v-�o 67 3. "gJ IS C(vmom N— M �u4A case 5. 5,4 11-6 6. ez�—C\,j It ale 7.M ECG t( R V 8. 9. 10. 4 T eC4-c� J SG GC Cn., r { J\1-r ojA val co fl L tn Li r 1 VENDOR APPUCAT=ON FOR TEMPORART FOOD EVENT The VENDOR of each temporary food event m prior to the opening event. This application mu: Emilia Capaccio ays Health Department, 1540 Sullivan Avenue, Sot Frank Capaccio This application is not a license. Tern p Temporary fi Roma Restaurant 358 Burnside Avenue 4PI404 TOday'S Bate " �p East Hartford,CT 06108 cell:413.537.9166 All Natural ltalian Pasta.Sauces to:860.282.0298 Name of Event Wapping Fair fak:860.289.6211 www.capadiroma.com Date of Event Sept.4 h-7th - - - - Time of Event 9/4_6 p.m.-10 p.m.; 9/5 6 p.m.- I I p.m. 9/6; 10 a.m. -11 p.m.; 9/7 10 a.m.-6 p.m. Location of Event Evergreen Walk(behind LA Fitness) Event Coordinator Paul Petrillo Event Coordinator Address PO Box 486 South Windsor,CT 06074 Event Coordinator Phone# 860-573-6780- Event Coordinator E-Mail Address WaPpingfair@aol.com Event Coordinator Phone#(cell, work&home)-(C) 860-573-6780(H) 860-632-1544 Name of Applicant (FI�l ��� C' Lo Name of Applicants Business(please indicate if mobile vendor o COY e` Applicants Address S-8 R v rn S t cal � � �� C 7- Applicants E-Mail Address 'Ct(�eS� Q& QC)( e or-,N Applicants Phone#(cell, work&home) , Set up time ` Please provide the following: (If any of the following does not apply to you put N/A) 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. t( � Q- Dc� 2 NAME OF EMPLOYEE PHONE# ADDRESS SHIFT 1. �i'��-i�� C��� .� �((3 22 50--) 1 .�53 �,+�rnS to P /� /d / 1 u (A3 id e / 3. [s A 4. 5. 6. 7. 8. 9. 10. ATTACHMENT #2 CHECKLIST FOR FOOD BOOTHIVENDOR 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 4 Garbage containers and plastic bags Hats/hair restraints _Crates, shelves to store food off of the ground y Gloves for food handling Hand washing station 5 CA "A/ 358 Burnside Avenue x East Hartford, CT 860-282-0298 Originated from Roma Restaurant Specializing in high quality pasta sauces, imported extra virgin olive oil and aged balsamic vinegar Find Our All Natural Specialties at these Fine Locations in Connecticut A Latte More ...Middlebury Labonne's .......Salsbury,Watertown,Woodbury . ......................... Bennie's Market.......................... Essex Marandino's ...................... New Hartford Bishop's Orchard .Guilford Michelle's Florals ....................... Vernon Center of the Plate.............Glastonbury Noel's Market ....................... Colchester Colonial Market............ Essex& Niantic Orchard Hill Market..................Branford Edge of the Woods .............New Haven Robert's Food Market..............Madison Fitzgerald's .......... Simsbury Scitico Market ............................ Enfield Garden of Light ...Avon & Glastonbury Shop Rite ............................ Manchester Gardiner's Market ...............Glastonbury Stew Leonard's..................... Newington Guilford Food Center ............... Guilford Sweet Sensations............ East Windsor Fromage Fine Foods....... Old Saybrook Ted's Market...............................Hebron Homestead Dairy East Hartford Westside Market .................... Rocky Hill Kane's....,................. Wild Raspberry................Simsbury p ry .......................Cromwell Whole Foods....................... Glastonbury Whole Foods....................West Hartford Big Y ..... Avon, East Hartford, East Windsor, Ellington, Manchester, North Haven,Plainville, Rocky Hill Geisslers ............................................ Bloomfield, East Windsor, Granby, South Windsor, Windsor Highland Park Markets.... Coventry, Farmington, Glastonbury, Manchester, South Windsor, Suffield Price Chopper..............................................Newington, Southington,Waterbury,Windsor,Vernon Find Our All Natural Specialties at these Fine Locations in Massachusetts Armata's ........................... Longmeadow Guido's ......... Great.Barrington, Pittsfield Arnold Meat.............. East Longmeadow Jack in the Beanstalk............. Falmouth Atkins Farm .............................. Amherst Lambert's Farm &Lee's ......... Westport Bartlett's Farm........................Nantucket Lenox Wine Cellar .......................Lenox Bruni's ...................................... Ipswitch McKinnon's ............... Danvers&Salem Chilmark .................................Nantucket Menemsha Market .... Martha's Vineyard Country Store .......... East Longmeadow Randall's Farm.......................... Ludlow Crosby's ............... Concord,Georgetown Ring Brothers .................. South Dennis ............... Manchester,Marblehead,Salem Romito's ................... East Longmeadow Domaney's ...................Great Barrington Storrowton Village At the ............ Big E Ethan's ...................... Martha's Vineyard Village Market.......................... Hamden Fresh Acres ....... ... ............Springfield Windfall Market ....................... Falmouth Fruit Center........... East Mllton,Hingham Whole Foods...............:.............. Hadley Geissler's ................. .............. Agawam Also Find Us In Rhode Island, New Hampshire, Maine & Vermont or at www.capadiroma.com 1 i Town of South Windsor Health Department Telephone(860)644-2511 Extension 248 Temporary Event - Food Inspection Name of Organization: G 'yyL-sS ��c Phone No.: Cell o.: 9 Z C'- ` ! Person-in-charge (PRINT): 5%4 ce i e' t,;Z Name &Address of Event: nry e 9„�- w � Date(s) of Event: 9 1,4 o g Hours of Operation: ♦ Hand Washing Setup: Ss"r ♦ Waste Water/Garbage Disposal: ♦ Approved Food&Water Source: iCtirs�-S c .st� ♦ Personal Hygiene:_ C:g-_ ♦ Thermometers/Alcohol Swabs: NJ ♦ Cold Temps(45°F or colder): N/Y", ♦ Coolers: % TV, fio 2 ♦ Hot Temps(140°F or hotter): C ♦ Internal Cooking Temps: CHECK FOOD TEMPERATURES THROUGH-OUT THE DAY*USE YOUR PROBE THERMOMETER ♦ Off-Site Preparation:Approved Commissary/Licensed Kitchen• 4-P, 14-\ M ♦ Cross-Contamination: e3s� Utensil Washing: Ar o-e �nr ♦ Sanitizer/Wiping Cloths: ar sr6 ♦ Food/Equipment/Single-Use Protection: - ♦ Self-Serve Food/Utensils Protected: ♦ Proper Construction/Smooth Cleanable Surfaces: ♦ Workers Log (Name,Address, Phone#, Dates &Times Worked) Keep.for 90 days__IS? ee y w\,,j ♦ Other: CORRECTIONS DUE IMMEDIATELY Food ety Information on Reverse Side I have read and hereby agree to fol w the Food Safety Information listed on the reverse sid of this form. PERSON IN CHAR E (Sign): 71C1 Date: Inspector: Date: 7 ( � i Giggles LLC A I Road Shelton, CT 06484 `r 203 926-8941 lecornCsnet.net Event: ► t Date, Q-h -7 7 p'/_,■� F Kettle C. fs- a o Y Bottled r Tent: front counter LM -� 0 -a m- �. C N b ettl� x Sources: BJ,s,Sam's Club, Costco, Restaurant Depot, Castle Beverages,New England Popcorn &Pretzel VENDOR APPLICATION FOR TEMPORARY FOOD EVENT The�fNDOR of each temporary food event must complete this application and must be filed 14 days prior to tI.ie opening event. This application must be submitted to the Town of South Windsor Health Department, 1540 Sullivan Avenue, South Windsor, cr 06074. This application is not a license. Temporary food permits will not exceed a period of I to 5 days, Today's Date Name of Event Wapping Fair - PatVf Event , Sept. 0'- 7th Time ofEvent--9/4 9/556p.m. - 11 p.r,1. 91-1; 11a.jyj. -Ii p.111. 9/7 10 a.m. -6 p.m. v Location of`Event Evergreen Walk(behind LA Fitness) EventCoordinator Paul Petrillo Event Coordinator Address POBox 486 South Windsor, CT 06074 Eve-at Coordinator Phone# 860-573-6780 Event Coordinator E-Mail Address- wappingofair@aol.corn. Event Coordinator Phone # (cell, work& home)_(C) 860-573-6780{II) 860-632-1544 ---- [NIN Name of Applicant T qQt&ZktP-) V Name of Applicants Business (please indicate if mobile vendor)—qiqqjea, Applicants Address Applicants E-Mail Address nex Applicants Phone#(cell, work&home) Set up time_ ? Please provide the following: (If any of the following does not apply to you put N/A) I.List all food and beverage items to be prepared and served (menu). Attach a separate sheet if necessai�,. K e-rric, wen , kit tvc- o-c-kk, cal � baoko�l 1910 60- NOTE: Any changes to the menu must be submitted to the Health Department 10 days prior to the event. C3 t y�- C.0-A IL6 s 2. Describe specifically how frozen, cold, and hot foods will be transported to the event. n 14 3. List all places (name& address) where meats, poultry, seafood, shellfish, and ice will be purchased. 4. List names, phone numbers, addresses, and shifts to be worked of all employees. See attachment #1. S. Use attachment #2 in this packet to sketch a drawing showing the event area and where your operation will be. Mapping pair will provide layout the week of the fair. 6. Describe the number, location and set up of handwashing facilities to be used by employees. i 7. Describe how and where utensil/equipment washing will take place. If no facilities are available, describe how alternate steps will be taken. 2 8. Describe how wastewater will be collected, stored and disposed. CDfv4vcL x,(ieA-, 9. Describe the number and location of garbage containers. Wapping Fair will have garbage containers located in area surrounding food areas 10. Describe what heat source will be used to keep hot foods hot (140 degrees and above). njA 11. Describe how colds foods will be kept cold (45 degrees and below). n1A 12. Describe how food temperatures aremonitored, cleaned and sanitized. 13. Will foods be prepared on site? If no, where will foods be purchased? (enclose copy of food license) rPTCZVO Po NAME OF EMPLOYEE PHONNE# ADDRESS SfHFT I. J� Z03 qZq. 313'7 1 B c Q Q 4. 5. 6. 7. 8. 9. 10} ATTACHMENT #2 CHECKLIST FOR FOOD BOOTHNENDOR 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 fonds, where is water to be drained) _-1IA—Plastic wrap/Aluminum foil ✓ Extra utensils: tongs, spatulas, spoons, and knives 11 Water source "Joe-A ✓ buckets/tubs for washing, rinsing, sanitizing food equipment ✓_Bleach for sanitizing, test strips for checking Waste water disposal container Iontainer(s) for grease collection _- dean wiping cloths and a container to store them in 4 �Carbage containers and plastic bags V Hats/hair restraints gates, shelves to store food off of the ground laves for food handling Hand washing station 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 UWfication is not a license. Temporary food permits will not exceed a period of I to 5 days, Today's Date - h) Name of Event L,,' ping Fair _J� Date of Event Sept. 4"'—7th Time of Event O/A 6 0 p.m. 9/5 6 p.m. — I I p-rn. 9/6; iv a.ra, -Il p.in.; 9/7 10 a.m. —6 p,m, Location of Event Evergreen Walk (behind LA Fitness)--.... Event Coordinator Paul Petrillo Event Coordinator Address—PO Box 486 South Windsor, CT 06074 Event Coordinator Phone # 860-573-6780 Event Coordinator E-Mail Address w ap p i n g,fai;r @ a o 1.c o m Event Coordinator Phone 4(cell, work& home)_(C) 860.-573-6780 (If) 860-632-1544 Name of Applicant Name of Applicants Business (please indicate if mobile vendor) Applicants Address Applicants E-Mail Address Applicants Phone 9(cell, work&home) 387 39 Set up time_ Please provide the following: (If any of the following does not apply to you put NIA) Uist 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. C/Lt 2. Describe specifically how frozen, cold, and hot foods will be transported to the event. List all places (name& address) where meats, poultry, seafood, shellfish, and ice will be purchased. 4. List names, phone numbers, addresses, and shifts to be worked of all employees. See attachment #1, S, Use attachment #2 in this packet to sketch a drawing showing the event area and where your operation will be. Wapping Fair will provide layout the week of the fair. 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. 8. Describe how wastewater will be collected, stored and disposed, 9. Describe the number and location of garbage containers. Wapping Fair will have garbage containers located in area surrounding food areas 10. Describe what heat source will be used to keep hot foods hot (140 degrees and above). 11. Describe how colds foods will be kept cold(45 degrees and below). 12. Describe how food temperatures are monitored, cleaned and sanitized. 0. Will foods be prepared on site? If no, where will foods be purchased? (enclose copy of food license) MAIME OF LOYEE j!H0NE# ADDRJ�SS SMFT 2. 3. 4. 5. 6, 7. 10, 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 4 G-arbage containers and plastic lags -- Hats/hair restraints Crates, shelves to store food off of"the ground Gloves for food handling Hand washirig station 5 South W�v+clsorJG��eees, {'.C3, gox 4g�, Sout�t wLv,,dsor, CTOC,07 t- www.wapp%v,,g fPLr.or9 July 14, 2008 Dear food vendor: The Town of South Windsor is changing their procedure regarding events that have temporary food vendors to ensure the overall safety of our fairgoers. I am enclosing the form that MIDST be completed by all our food vendors and returned. These forms must be on file with the town health department at least 10 days prior to the event. I have answered a few of the questions that the Wapping Fair directly handles. Please feel free to contact Robert Devito, Sanitarian for the Town of South Windsor, at 860-644- 2511 X248 with any questions. He is aware this is the first time any of our vendors are completing these forms and is more than happy to assist in the process. Please return these forms to me as soon as possible, so I can make sure they everybody is meeting all the requirements. Forms may be mailed to: Wapping Fair, P4 Box 486, South Windsor, CT 06074 Sincerely Paul Petrillo Chairman Wapping Fair 860-573-6780 Town of South Windsor Health Department Telephone(860)644-2511 Extension 248 Temporary Event — Food Inspection Name of Organization:_ rA V�4 Phone No.: Cell No.: Person-in-charge(PRINT): Name &Address of Event: Date(s) of Event: 61 —/D Hours 6f Operation: r Y —�'> _______________=====_______________________________________ ♦ Hand Washing Setup: �aj ♦ Waste Water/Garbage Disposal: ftiJ , L d ♦ Approved Food&Water Source: ♦ Personal Hygiene: ♦ Thermometers/Alcohol Swabs: 1. e ♦ Cold Temps (45°F or colder)- (� i� ♦ Coolers: ♦ Hot Temps(140°F or hotter): L� ♦ Internal Coolang Temps: f CHECK FOOD TEMPERATURES THROUGH-OUT THE DAY*USE YOUR PROBE THERMOMETER ♦ Off-Site Preparation: Approved Con)missary/ Licensed Kitchen:_ V y/ I� I�Jja ♦ Cross-Contamination: Utensil Washing: ♦ Sanitizer/Wiping Cloths: ♦ Food/ Equipment/Single-Use Protection: ♦ Self-Serve Food/ Utensils Protected: ♦ Proper Construction/Smooth Cleanable Surfaces: ♦ Workers Log (Name, Address, Phone#, Dates& Times Worked) Keep for 90 days CORRECTIONS DUE IMM DIATELY ♦ Other: �, � .� — C( Food Safety Information on Reverse Side have read and hereby agree to follow the Food Safety Information listed on the reverse side of this form. PERSON IN CHARGE (Sign): Date: Inspector: Date: 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 August 8 2008 Name of Event Wapping Fair Date of Event Sept. 4'—7th Time of Event 9/4—6 p.m.-10 p.m.; 9/5 6 p.m.— 11 p.m. 9/6;-10 a.m. -11 p.m.; 9/7 10 a.m. —6 p.m. Location of Event_Evergreen Walk(behind LA Fitness) Event Coordinator Paul Petrillo Event Coordinator Address—PO Box 486 South Windsor, CT 06074 Event Coordinator Phone# 860-573-6780 Event Coordinator E-Mail Address wappingfair@aol.com Event Coordinator Phone# (cell,work&home)_(C) 860-573-6780 (H) 860-632-1544_ Name of Applicant Cary Prague Name of Applicants Business (please indicate if mobile vendor) South Windsor Republicans Applicants Address 60 Krawski Dr. South Windsor, CT O6074 Applicants E-Mail Address dbcreate aol.com Applicants Phone# (cell, work&home) 860 985-5180 Set up time Thursday, September 4,Noon-4:OOPM (non-cooking) Friday, September 5 5:00 pin(cooking 2 Please provide the following: (If any of the following does not apply to you put N/A) 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. Menu: Pierogi Plate: $4.00 5 pierogies with cooked onion. Pierogies could be boiled or fried on skillet w/butter and/or oil Kielbasa Sandwich: $4.00 1 Bulkie Type Roll or Potato Hot Dog Roll 4 oz Kielbasa(Cooked on Grill or in Pans) Optional Onions Polish Plate: $5.00 4 pierogies with cooked onion. 3 oz. Kielbasa sliced (Cooked on Grill or in Pans) Optional Onions Mrs. T's Pierogies (frozen in bags)purchased from SAMS Club each day Kielbasa(fresh from SAMS Club each day Rolls (purchased fresh each day from SAMS) Onions (purchase fresh each day sliced from Highand Park) Sauerkraut(canned) Condiments (Mustard, Relish) Water in Bottles, Soda in Cans (Undecided) 2. Describe specifically how frozen, cold, and hot foods will be transported to the event. Bagged Frozen food will be immediately placed in coolers with ice for transport and storage. Maximum storage time 48 hours (Frozen Pierogies may be used thawed within 48 hours) Excess Frozen Food will be stored in a Freezer on-site Kielbasa will be stored in coolers with ice. Maximum 48 hours. Onions will be stored in refrigerator. No hot food will be transported. 2 3. List all places (name & address)where meats,poultry, seafood, shellfish, and ice will be purchased. Kielbasa(Fresh) and Piergoies (Frozen)—SAMS Club,Manchester Butter(refrigerated) SAMS Club Oil in bottles SAMS Club Sauerkraut(Canned) Condiments (Bottled) Fresh Chopped Onions—Highland Park Water—SAMS Club Ice—SAMS Club or on-site from Jaycees Plates and bowls from SAMS. ToGo Containers from SAMS 4. List names,phone numbers, addresses, and shifts to be worked of all employees. See attachment#1. Cary Prague, 985-5180, 60 Krawski Dr. South Windsor,All Shifts Karen Prague, 985-5180, 60 Krawski Dr. South Windsor, All Shifts John Samsel, 644-6515, 304 Abbe Rd Ext, South Windsor, All Shifts Terry Samsel, 644-6515, 304 Abbe Rd Ext, South Windsor, Most Shifts Bill Aman, 528-3564, 878 Strong Rd, South Windsor, Some Shifts Marti Aman, 528-3564, 878 Strong Rd, South Windsor, Some Shifts Jan Snyder, 644-4901, 191 Bourbon St, South Windsor, Some Shifts Teri-Gaignat, 644-3869, 30 Devonshire Dr, South Windsor, Some Shifts All people will wear baseball type caps. 3 5. Use attachment#2 in this packet to sketch a drawing showing the event area and where your operation will be. Wapping Fair will provide layout the week of the fair. There will be one grill person and one helper at all times. Helper will also maintain condiment table and clean it often 2 Servers of which one will take money. Expect four persons max in booth. 2 feet G RI L TABLE REFER FREEZER :ni Z � W M Wes' MJ CL C Co Z & SERVING TABLE 6. Describe the number, location and set up of handwashing facilities to be used by employees. Our one hand washing station will be a 5 gallon sealed insulated container of hot water. It will be on a small table with a bucket underneath. We will have a roll of hand towels and a bottle of sanitizing hand soap. We will have two 5 gallon buckets on site Saturday and Sunday. 7. Describe how and where utensil/equipment washing will take place. If no facilities are available, describe how alternate steps will be taken. We will be using long grill tongs and spatulas, and large knives. We have a stainless steel grill but will be cutting on one of two long white cutting boards. We will have a plastic pan which after sanitizing will be used to clean the tools as needed with some type of cleaning solution and water when they get dirty enough to clean. We will have three sets of tools for the one grill person. 8. Describe how wastewater will be collected, stored and disposed. There will be a plastic bucket that will collect waste waterWe wi 1 take the bucket to an unused area of the fair and dump it when dirty 4 9. Describe the number and location of garbage containers. We will have one container inside the booth with black plastic bag liners. We will also have a separate large Tupperware type container for grease collection if any. That will be taken to our home each night, and cleaned. Wapping Fair will have garbage containers located in area surrounding food areas 10. Describe what heat source will be used to keep hot foods hot(140 degrees and above). We will have a 6 ft propane stainless steel grill with six burners on site. We will also have a propane burner for boiling water along side the grill. 11. Describe how colds foods will be kept cold(45 degrees and below). We will have electric refrigerators and freezers on site. Unused unopened food will be transported to our home in coolers (about 5 minute ride) and stored in freezers or refrigerators). Opened food will be thrown out each day. 12. Describe how food temperatures are monitored, cleaned and sanitized. We will have digital thermometers to check the kielbasa and a analog thermometer in the refri erator and freezer and all coolersae will clean the kielbasa thermometer by rubbing it in the dirt Podunk dirt is clean and sanitizing. 13. Will foods be prepared on site? If no,where will foods be purchased? (enclose copy of food license) All cooked food will be prepared on site. Chopped fresh onions will be put in pans, butter and oil added and steamed/stored on grill all day. We expect to cook in small pans each hour and throw out unused onions each hour or two based on look. Kielbasa will be grilled on open flames or cooked with onions in frying pans. Pierogies will be boiled in water and served on request or most will be cooked in pans with butter and oil. Cooked onions will be cooked with pierogies upon request. Food Licenses are not needed in South Windsor according to state for temporary vendors at fairs. 5 Will be completed closer to fair dates NAME OF EMPLOYEE PHONE# ADDRESS SHIFT 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 6 Town of South Windsor Health Department Telephone(860) 644-2511 Extension 248 Temporary Event — Food Inspection n (_03)L -15 yy Name of Organization: \1 ►N c-► phone o.: Cell No.: 5--7S Person-in-charge (PRINT): g Er's V,N C_ Name &Address of Ev nt: Date(s) of Event: 9�y v Hours of Operation: ♦ Hand Washing Setup: ♦ Waste Water/Garbage Disposal: ♦ Approved Food&Water Source: Personal Hygiene: 175� ♦ Thermometers/Alcohol Swabs: ♦ Cold Temps(45°F or colder): ♦ Coolers: ♦ Hot Temps(140°F or hotter): Ga -�, ♦ Internal Cooldng Temps: CHECK FOOD TEMPERATURES THROUGH-OUT THE DAY*USE YOUR PROBE THERMOMETER ♦ Off-Site Preparation:Approved Commissary/Licensed Kitchen: ♦ Cross-Contamination: Utensil Washing: ♦ Sanitizer/Wiping Cloths: ♦ Food/Equipment/Single-Use Protection: ♦ Self-Serve Food/Utensils Protected: ♦ Proper Construction/Smooth Cleanable Surfaces: ♦ Workers Log (Name,Address, Phone#, Dates &Times Worked) Keep.for 90 days CORRECTIONS DUE IMMEDIATELY ♦ Other:_ i U [ 64u [ Food Safety Information on Reverse Side I have read and hereby agree to follow the Food Safety Information listed on the reverse side of this form. PERSON IN CHARGE (Sign): Date: or•Inspect Date: �� u VENDOR APPLICATION AND GUIDELINES FOR TEMPORARY FOOD SERVICE EVENTS H:\ppetrillo\Wapping Fair\Work\TempomryFoodCoordinatorApplication2007\TemporaryFoodVendorApplication2007.doc CTDOCS:25986.1 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 8/27/08 Name of Event Wapping Fair Date of Event Sept. 4'—7th Time of Event 9/4_6 p.m.-10 p.m.; 9/5 6 p.m.— 11 p.m. 9/6; 10 a.m. -I I p.m.; 9/7 10 a.m.—6 p.m. Location of Event Evergreen Walk(behind LA Fitness) Event Coordinator Paul Petrillo Event Coordinator Address PO Box 486 South Windsor, CT 06074 Event Coordinator Phone# 860-573-6780 Event Coordinator E-Mail Address wappingfair@aol.com Event Coordinator Phone#(cell,work&home)_(C) 860-573-6780 (H) 860-632-1544 Name of Applicant Ben Vinci Name of Applicants Business (please indicate if mobile vendor)_ Vinci Concessions Applicants Address_ 20 Clover Hill Place Kensington, Ct 06037 Applicants E-Mail Address_ kvinci@comcast.net Applicants Phone#(cell, work&home)_ (w)_860-965-2995 Set up time 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. Fried Dough, soda CCDOCS:25986.1 2 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. none 3. List all places(name&address)where meats,poultry, seafood, shellfish, and ice will be purchased. Ice purchased at Sam's club 4. List names,phone numbers, addresses, and shifts to be worked of all employees. See attachment#1. Mike Vinci 20 clover hill pl Kensington, ct 860-829-1557 Ben V inci same address and phone Kathy Vinci same address and phone Anthony Vinci same adderss and phone 5. Use attachment#2 in this packet to sketch a drawing showing the event area and where your operation will be. Wapping Fair will provide layout the week of the fair. 6.Describe the number, location and set up of handwashing facilities to be used by employees. In trailer sink hot and cold running water, liquid hand soap,paper towels 7. Describe how and where utensil/equipment washing will take place. If no facilities are available, describe how alternate steps will be taken. In trailer 8. Describe how wastewater will be collected, stored and disposed. In gray water holding tank and taken home 9. Describe the number and location of garbage containers. Wapping Fair will have garbage containers located in area surrounding food areas 10. Describe what heat source will be used to keep hot foods hot(140 degrees and above). CTDOCS:25986.1 2 Cooked per order 11. Describe how colds foods will be kept cold(45 degrees and below). none 12. Describe how food temperatures are monitored, cleaned and sanitized. N/A 13. Will foods be prepared on site? If no, where will foods be purchased? (enclose copy of food license) y NAME OF EMPLOYEE PHONE# ADDRESS SHIFT 1.Ben Vinci 860-829-1557 20 clover hill pl Kensington ct 2.Mike Vinci Same CTDOCS:25986.1 3 3.Anthony Vinci Same 4.Kathy Vinci Same 5. 6. 7. 8. 9. 10. 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 CTDOCS:25986.1 4 Gloves for food handling Hand washing station CTDOCS:25986.1 5 10WN �� Wo� V/ Sau� 7� O m � w� &U&01t 1540 SULLIVAN AVENUE • SOUTH WINDSOR, CT 06074 S R•CC;' TELEPHONE (860) 644-2511 CERTIFIED MAIL 7004 2510 0003 9803 0369 August 28, 2007 Mr. Paul Petrillo Wapping Fair Association, Inc. P. O. Box 486 South Windsor, CT 06074 Re: Appl#07-50P, Wapping Fair Dear Mr. Petrillo: In accordance with the Planning&Zoning approval of August 21, 2007 for a one year or five- year(2007, 2008, 2009, 2010, 2011)permit under Section 3.17.1 of the Zoning Regulations to hold a fair at the Rye Street Park,your new dates are as follows: September 6, 2007 6:00 p.m. to 11:00 p.m. September 7, 2007 6:00 p.m. to midnight September 8, 2007 11:00 a.m. to midnight September 9, 2007 11:00 a.m. to 6:00 p.m. The following conditions shall apply: 1. Acknowledge this is private property; notwithstanding any requirements set forth in this letter, all activities and site modifications require the property owner's approval. 2. Police Services shall be the responsibility of Jaycees as agreed to by the South Windsor Police Services at the annual pre-fair meeting. 3. Parking&"No Parking"to be coordinated with property owners & SWPD.No parking along Evergreen Way, Tamarack, Hemlock, Cedar. 4. All parking areas shall be clearly marked. 5. A minimum of nine portable sanitary facilities shall be provided 6. Adequate trash receptacles &removal 7. The fireworks area is to be condoned off per Fire Marshal's requirements 8. A list of Jaycees Wapping Fair Committee contacts and phone numbers shall be provided to the Town. A reciprocal list of critical Town contacts will be provided to the Jaycees Wapping Fair Committee. 9. The Jaycees Fair staff shall be readily identifiable as such while working the fairgrounds. 10. The Jaycees must contact the Planning Department each spring advising us of the dates for that year and any changes there may be from the original approval granted with staff ability to review. Sincerely, 1194"V,--- c Patrick Kennedy, Chairmz Planning&Zoning Commission PK/ma cc: Gary Tyler, Police Chief Walter Summers, Fire Marshal Robert Deptula, Environmental Health Officer Town Attorney Karl Reichle, Superintendent of Operations Chris Dougan, Chief Building Official Ray Favreau, Director of Recreation LEGAL SERVICES REQUEST FORM NAME: GJ ey l c` DEPARTMENT OR BOARD/COMMISSION: APPROVED BY DEPARTMENT HEAD OR CHAIRPERSON: TYPE OF SERVICE REQUESTED: (Check Appropriate Box) Legal Opinion ❑ Review Contract or Other Document ❑ Litigation (Specify Document Below) ❑ Attend Meeting ❑ Prepare Contract or Other Document C--Other (Specify Document Below) {Specify Below) FACTS: (Overview of Facts Surrounding Question Presented or Service Requested) (If more space needed, use reverse side of form.) ��JuJ� hl�Gb✓�"r3'L' i � dCwCL�� !f��>°�GG�v��-d dk�o �1^®vK.a y r v Wk mg 4 I l h49"+Ael) 6 r�/`/err o f r-4 0"r li i q vy k y ®Y-v c,I-L et� a;P 7lw 1?�cc�J?i�r� Fa f,r (fop QUESTION TO BE ANSWERED OR SPECIFIC SERVICE REQUESTED: (If more space needed, use reverse side of form.) Date of Request: q v v�� v� /lY Requested Due Date: �� � *Date Received by Town Atty's Office: *Date File Opened: *Provide Status Update: *Date Completed: *To be completed by Town Attorney's Office q"W H Sf4 ti F T_0� O-P Sou� C U :. wC, 1540 SULLIVAN AVENUE• SOUTH WINDSOR, CT 06074 I�OsoR•c° TELEPHONE (860) 644-2511 CERTIFIED MAIL 7004 2510 0003 9803 0406 August 28, 2007 Mr. Paul Petrillo Wapping Fair Association, Inc. P. O. Box 486 South Windsor, CT 06074 Re: Appl#07-50P, Wapping Fair Dear Mr. Petrillo: In accordance with the Planning&Zoning approval of August 21,2007 for a one year or five- year(2007,2008, 2009, 2010, 2011)permit under Section 3.17.1 of the Zoning Regulations to hold a fair at the property located on the west side of Buckland Road, west of L.A Fitness your new dates are as follows: September 6, 2007 6:00 p.m. to 11:00 p.m. September 7, 2007 6:00 p.m. to midnight September 8, 2007 11:00 a.m. to midnight September 9, 2007 11:00 a.m. to 6:00 p.m. The following conditions shall apply: 1. Acknowledge this is private property; notwithstanding any requirements set forth in this letter, all activities and site modifications require the property owner's approval. 2. Police Services shall be the responsibility of Jaycees as agreed to by the South Windsor Police Services at the annual pre-fair meeting. 3. Parking&"No Parking"to be coordinated with property owners & SWPD.No parking along Evergreen Way, Tamarack, Hemlock, Cedar. 4. All parking areas shall be clearly marked. 5. A minimum of nine portable sanitary facilities shall be provided 6. Adequate trash receptacles&removal 7. The fireworks area is to be condoned off per Fire Marshal's requirements 8. A list of Jaycees Wapping Fair Committee contacts and phone numbers shall be provided to the Town. A reciprocal list of critical Town contacts will be provided to the Jaycees Wapping Fair Committee. t 0*N Sfq C y � 1540 SULLIVAN AVENUE • SOUTH WINDSOR, CT 06074 f�OSOR-CO TELEPHONE(860)644-2511 August 24, 2007 CERTIFIED MAIL 7004 2510 0003 9803 0048 Mr. Jack Fanelli Fanelli Amusement Company 47 Barrett Road Greenville, NH 03848 Mr. Fanelli, As you-may recall, we had a discussion at last year's Wapping Fair regarding the discharge of sewage from your trailers /mobile homes directly onto the ground. This, as you may be aware is not a legal activity in the State of Connecticut per the State Public Health code. Please provide an acceptable disposal method for this year's Wapping Fair and have it in place prior to the opening of the fair. I can be contacted at the South Windsor Town Hall, (860)644-2511 ext.248 with questions as to what is or is not an acceptable disposal method. Yours truly, Robert Deptula, R.S. Environmental Health Officer RD/cm Cc: Mr. Paul Petrillo Wapping Fair P 0 Box 486 South Windsor, CT 06074 ORDER OF THE DIRECTOR OF HEALTH ISSUED TO: Mr. Jack Fanelli Fanelli Amusement Company, 47 Barrett Road Greenville, NH 03848 You are hereby notified of the existence of a public health law violation upon the premises owned by you or under your charge, located at 151 Buckland Road in the town of South Windsor and described as follows: Unapproved discharge of sewage from trailer/mobile homes associated with the Wapping Fair. LAW VIOLATIONS: 19-13-B103c a 19-1 -13103c b 19-1313103c f 1 -13-B1 d . AUTHORITY: Connecticut General Statutes Sections 19a-206, 19a-207, 19a-244. PENALTY: Connecticut General Statutes Sections 19a-36, 19a-206, 19a-230. It is hereby ordered that said violation(s) be removed, abated, or corrected by immediately upon the receipt of this notice. Dated today, the 8 of September, 2007. r Dr. Gerald Schwartz Director of Health South Windsor Health Department METHOD OF SERVICE RIGHT OF APPEAL: There are two ways to appeal this order, both methods require action within 3 business days after you receive the Order. (1) You may appeal the decision by delivering your written appeal to the Department within 3 business days hours after you receive the Order. You may deliver it to the Department either in person or by facsimile. The Department's address and facsimile number are: Department of Public Health Public Health Hearing Office 410 Capitol Avenue Hartford, CT Facsimile: (860) 509-7553 If you chose this method of appeal, you need do nothing more to perfect your appeal, unless instructed otherwise by the Department. (2) You may also appeal the Order by calling the Department within 3 business days of receipt of the Order at one of the following numbers: (860) 509-7648 or(888) 891-9177. If you call on a weekend or after business hours, it is sufficient to leave a message with your name, number and a description of the Order you are appealing. Order of the director of health,page 2 If you appeal the order by calling one of the telephone numbers listed above, the telephone call must be followed up with a written notice of appeal that must be received by the Department within ten days of the telephonic notice. PLEASE NOTE: It is not sufficient that the written notification be postmarked within ten days. It must be received by the Department within ten days. Delays caused by the Post Office will not excuse failure to comply with this requirement. The written notice of appeal following the telephonic notice may be delivered to the Department in person, by facsimile, or by first class or certified mail. The Department's address and facsimile number are provided above. If you chose to send the written notice of appeal by first class mail or certified mail, please use the addresses provided below. First Class Mail: Send written appeals by first class mail to the following address: Department of Public Health Public Health Hearing Office 410 Capitol Avenue MS 13 PHO P.O. Box 340398 Hartford, CT 06134-0308 Certified Mail: Send written appeals by certified mail to the following address: Department of Public Health Public Health Hearing Office 410 Capitol Avenue MS 13 PHO Hartford, CT 06106 Connecticut General Statutes § 19a-229 states, "Any person aggrieved by an order issued by a town, city or borough director of health may, within three business days after the making of such an order, appeal to the commissioner of public health, who shall thereupon immediately notify the authority from whose order the appeal was taken, and examine into the merits of such case, and may vacate modify, or affirm such order." The Regulations of Connecticut State Agencies provides: Sec. 19a-9-8: Date due when due date falls on a date the department is closed. If the last day of any statutory or regulatory time frame falls on a day on which the department is closed, any paper may be filed or any required action may be taken on the next business day the department is open. Such filing or action shall be deemed to have the same legal effect as if done prior to the expiration of the time frame. Sec. 19a-9-14: Appeals of orders issued by a town, city, borough, or district director of health. (a) Any person aggrieved by an order issued by a local director of health may appeal said order to the commissioner. (b) The notice of appeal shall be filed with the commissioner within 3 business days after the receipt of said order Order of the director of health,page 3 (c) The notice of appeal shall state: (1) the name, address, and telephone number of the person claiming to be aggrieved; (2) the name of the issuing authority; (3) the way in which the order adversely affects the person claiming to be aggrieved; (4) the order being appealed; and (5) the grounds for appeal. (d) Telephonic notice of appeal to the office of the commissioner shall be satisfactory as the initial notice of appeal, provided written notice of appeal from the person claiming to be aggrieved is received by the department within ten (10) days of the telephonic notice. (e) An appeal from an order issued by a town, city or borough, or district director of health shall be a de novo proceeding in accordance with the regulations governing contested cases as set forth in section 1 9a-9-1 through 1 9a-9-29 of the Regulations of Connecticut State Agencies. (f) Any order issued by a town, city, borough, or district director of health shall include a notice of the right to appeal which shall indicate the name and telephone number of the commissioner(Commissioner of Public Health Dr. J. Robert Galvin, M.D., M.P.H. (860) 509-7101) or the commissioner's designee (Diane Buzzetti (860) 509-7648), and shall be accompanied by copies of sections 19a-9-8 and 19a-9-14 of the Regulations of Connecticut State Agencies. ORDER OF THE DIRECTOR OF HEALTH ISSUED TO: Mr. Jack Fanelli:, Fanelli Amusement Company, 47 Barrett Road, Greenville, NH 0848 You are hereby notified of the existence of a public health law violation upon the premises owned by you or under your charge, located at 151 Buckland Road in the town of South Windsor and described as follows: Unapproved discharge of sewage from trailer/mobile homes associated with the Wapping Fair. LAW VIOLATIONS: 19-13-13103c(a). 19-13-13103c(b), 19-13B103c(f), 19-13-131(d). AUTHORITY: Connecticut General Statutes Sections 19a-206, 19a-207, 19a-244. PENALTY: Connecticut General Statutes Sections 19a-36, 19a-206, 19a-230. It is hereby ordered that said violation(s) be removed, abated, or corrected by immediately upon the receipt of this notice. Dated today, the 9 of September, 2007. / V V Dr. Gerald Schwartz Director of Health South Windsor Health Department METHOD OF SERVICE RIGHT OF APPEAL: There are two ways to appeal this order, both methods require action within 3 business days after you receive the Order. (1) You may appeal the decision by delivering your written appeal to the Department within 3 business days hours after you receive the Order. You may deliver it to the Department either in person or by facsimile. The Department's address and facsimile number are: Department of Public Health Public Health Hearing Office 410 Capitol Avenue Hartford, CT Facsimile: (860) 509-7553 If you chose this method of appeal, you need do nothing more to perfect your appeal, unless instructed otherwise by the Department. (2) You may also appeal the Order by calling the Department within 3 business days of receipt of the Order at one of the following numbers: (860) 509-7648 or(888) 891-9177. If you call on a weekend or after business hours, it is sufficient to leave a message with your name, number and a description of the Order you are appealing. Order of the director of health,page 2 If you appeal the order by calling one of the telephone numbers listed above, the telephone call must be followed up with a written notice of appeal that must be received by the Department within ten days of the telephonic notice. PLEASE NOTE: It is not sufficient that the written notification be postmarked within ten days. It must be received by the Department within ten days. Delays caused by the Post Office will not excuse failure to comply with this requirement. The written notice of appeal following the telephonic notice may be delivered to the Department in person, by facsimile, or by first class or certified mail. The Department's address and facsimile number are provided above. If you chose to send the written notice of appeal by first class mail or certified mail, please use the addresses provided below. First Class Mail: Send written appeals by first class mail to the following address: Department of Public Health Public Health Hearing Office 410 Capitol Avenue MS 13 PHO P.O. Box 340398 Hartford, CT 06134-0308 Certified Mail: Send written appeals by certified mail to the following address: Department of Public Health Public Health Hearing Office 410 Capitol Avenue MS 13 PHO Hartford, CT 06106 Connecticut General Statutes § 19a-229 states, "Any person aggrieved by an order issued by a town, city or borough director of health may, within three business days after the making of such an order, appeal to the commissioner of public health, who shall thereupon immediately notify the authority from whose order the appeal was taken, and examine into the merits of such case, and may vacate modify, or affirm such order." The Regulations of Connecticut State Agencies provides: Sec. 19a-9-8: Date due when due date falls on a date the department is closed. If the last day of any statutory or regulatory time frame falls on a day on which the department is closed, any paper may be filed or any required action may be taken on the next business day the department is open. Such filing or action shall be deemed to have the same legal effect as if done prior to the expiration of the time frame. Sec. 19a-9-14: Appeals of orders issued by a town, city, borough, or district director of health. (a) Any person aggrieved by an order issued by a local director of health may appeal said order to the commissioner. (b) The notice of appeal shall be filed with the commissioner within 3 business days after the receipt of said order Order of the director of health,page 3 (c) The notice of appeal shall state: (1) the name, address, and telephone number of the person claiming to be aggrieved; (2) the name of the issuing authority; (3) the way in which the order adversely affects the person claiming to be aggrieved; (4) the order being appealed; and (5) the grounds for appeal. (d) Telephonic notice of appeal to the office of the commissioner shall be satisfactory as the initial notice of appeal, provided written notice of appeal from the person claiming to be aggrieved is received by the department within ten (10) days of the telephonic notice. (e) An appeal from an order issued by a town, city or borough, or district director of health shall be a de novo proceeding in accordance with the regulations governing contested cases as set forth in section 1 9a-9-1 through 1 9a-9-29 of the Regulations of Connecticut State Agencies. (f) Any order issued by a town, city, borough, or district director of health shall include a notice of the right to appeal which shall indicate the name and telephone number of the commissioner(Commissioner of Public Health Dr. J. Robert Galvin, M.D., M.P.H. (860) 509-7101) or the commissioner's designee (Diane Buzzetti (860) 509-7648), and shall be accompanied by copies of sections 19a-9-8 and 19a-9-14 of the Regulations of Connecticut State Agencies. AND WELL-BEING Title 368e MUNICIPAL HEALTH AUTHORITIES 941 )m one dollar and thirteen cents to ninety-four cents effecti `records are the registrars of vital statistics of their respective towns,boroughs and cities ` for the period for which they were respectively appointed.Each town,borough and city ialities with part-time health depart me director of health, before entering upon the duties of his office, shall be sworn to the ilations.(a)Upon application to the Dept_ faithful discharge thereof. ilth department shall annually receive fro =-(1949 Rev,S.3849;1955,S.2066d;1967,P.A.59,S.1;P.A.77-614,S.323,610;P.A.93-381,S.9,39;P.A.95-257, its per capita. _ 5.12,21,58.) History:1967 act substituted clerk of the municipality for probate court clerk as recorder of appointment;P.A.77-614 self as having a part-time health departmen replaced commissioner of health with commissioner of health services,effective January 1,1979;Sec.19-77 transferred ime health department Or been lri a full tim to Sec.19a-204 in 1983;P.A.93-381 replaced commissioner of health services with commissioner of public health and :addiction services,effective July 1, 1993;P.A.95-257 replaced Commissioner and Department of Public Health and he municipality has the equivalent of at lea -Addiction Services with Commissioner and Department of Public Health,effective July 1,1995;(Revisor's note:In 2001 (3)file the references in this section to the date"19.:'were changed editorially by the Revisors to"20.."to reflect the new the Commissioner of Public Health, lth program plan and budget to the comtru_S- 'millennium). the program plan and budget. Sec. 19a-205. (Formerly Sec.19-78).Salaries of directors of health.Each town director of health shall be paid by the treasurer of the town in which he has exercised i shall adopt regulations,in accordance twit oment and approval of the program plan an the duties of his office for his actual services and necessary expenses. Bills for actual ection(b)of this section. _ services and necessary expenses shall be rendered by each town director of health on S.2,28;June 30 Sp.Sess.P.A.03-3,S.2.) the first days of April,July,October and January for the preceding three months.Each - city and borough director of health shall receive such compensation as is fixed by the nended Subdiv.(3)of Subsec.(b)to require that the munrcip dget to the commissioner"rather than"develops a p)an 'common council or burgesses of the city or borough for which he is appointed,but, if -sec.(c)to change"plan and timetable"to"program plan aft such compensation is not so fixed,he shall receive payment for his actual services and Subsec.(a)to increase annual per capita payment from fl necessary expenses. Sp.Sess.P.A.03-3 amended Subsec.(a)to decreaseannu effective August 20,2003. (1949 Rev.,S.3631;P.A.77-614,S.323,610;P.A.92-8,S.1.) History:P.A.77-614 replaced commissioner of health with commissioner of health services,effective January 1,1979; )alities: Distribution of excess funds l 0 F sec.19-78 transferred to Sec.19a-205 in 1983;P.A.92-8 deleted requirement that commissioner of health services approve Is appropriated in excess of the requirempn_ salaries. Shall be distributed based On the pro i a a Annotation to former section 19-78: ears to the total for these sections. "Expenses"defined.76 C.167. -Sec. 19a-206. (Formerly Sec. 19-79).Duties of municipal directors of health. Nuisances and sources of filth.Injunctions.Civil penalties.Authority of town direc- ). "Director of health" substitute d='for for within'city or borough. (a) Town, city and borough directors of health or their ed,effective October 1,2002. :authorized agents shall,within their respective jurisdictions,examine all nuisances and sources of filth injurious to the public health, cause such nuisances to be abated and cause to be removed all filth which in their judgment may endanger the health of the Certificate of appointment to be file inhabitants. Any owner or occupant of any property who maintains such property, ' Whether real or personal,or any part thereof,in a manner which violates the provisions wn,,borough of city director of health sh tlth by the person making such appointrnen of the Public Health Code enacted pursuant to the authority of sections 19a-36 and 19a- y special act,the registrar of vital statistic .37 shall be deemed to be maintaining a nuisance or source of filth injurious to the public h appointment shall,within ten days,dr s- -.health. Any local director of health or his authorized agent or a sanitarian authorized clerk of the municipality for which sue by such director may enter all places within his jurisdiction where there is just cause to >uch appointment. Such notice shall be ;suspect any nuisance or source of filth exists, and abate or cause to be abated such nuisance and remove or cause to be removed such filth. n the .... day of ..... A.D. 20.. Directoro (b) When any such nuisance or source of filth is found on private property, such d, under special act,the registrar of birI director of health shall order the owner or occupant of such property,or both,to remove city)from the....day of....,A.D.20 un_ -or abate the same within such time as the director directs.If such order is not complied ,s with,within the time fixed by such director: (1) Such director, or any.official of such town, city or borough authorized to institute actions on behalf of such town, city or Certification and Signatu . borough,may institute and maintain a civil action for injunctive relief in any court of competent jurisdiction to require the abatement of such nuisance,the removal of such i book kept by him for the purpose,re co filth and the restraining and prohibiting of acts which caused such nuisance or filth,and illy certify that the persons named in suc itch court shall have power to grant such injunctive relief upon notice and hearing;(2) 942 PUBLIC HEALTH AND WELL-BEING Title 19a Ch, 368e MUNICIPAL HEA the owner or occupant of such property, or both, shall be subject to a civil penalty of see See.26-192g re duties of local directors of health v two hundred fifty dollars per day for each day such nuisance is maintained or such filth or posted areas.Annotations to former season 19-79: allowed to remain after the time fixed by the director in his order has expired, except Towns not liable for acts of health officers,acting in gt that the owner or occupant of such property or any part thereof on which a public eating not liable for error of judgment when acting in good faith. place is conducted shall not be subject to the provisions of this subdivision, but shall = power of health officer.Id.,98,99.Filth and nuisances may 1 Id.,102.Duty to prevent spread of disease.86 C.677,A f be subject to the provisions of subdivision.(3). Such civil penalty may be collected in ;the time allowed in an order for compliance with its terms a civil proceeding by the director of health or any official of such town,city or borough First selectmen of towns have never possessed any auth authorized to institute civil actions and shall be payable to the treasurer of such city, history and purpose discussed;the nuisances referred to at Annotations to present section: town or borough, and (3) the owner or occupant of such property, or both, shall be Cited.42 CA 631. subject to the provisions of sections 19a-36, 19a-220 and 19a-230. Sec. 19a-207. (Formerly Sec. 19-8( (c) If the director institutes an action for injunctive relief seeking the abatement of egulations.The local director of health t a nuisance or the removal of filth, the maintenance of which is of so serious a nature= all enforce or assist in the enforcement o: as to constitute an immediate hazard to the health of persons other than the persons<. may be adopted by the""Commissioner c maintaining such nuisance or filth,he may,upon a verified complaint stating the facts retain the power to adopt,by ordinanc which show such immediate hazard,apply for an ex parte injunction requiring the abate s_ Ie or regulation shall be inconsistent wit ment of such nuisance or the removal of such filth and restraining and prohibiting the; , ommissioner. In any emergency when th acts which caused such nuisance or filth to occur,and for a hearing on an order to showy y local board of health or director of hea cause why such ex parte injunction should not be continued pending final determination e Department of Public Health,said depl on the merits of such action.If the court finds that an immediate hazard to the health, ' required for the protection of the public persons other than those persons maintaining such nuisance or source of filth exists„ :_ �1949 Rev.,S.3806;1957,P.A.13,S.84;P.A.77-614 such ex parte injunction shall be issued,provided a hearing on its continuance pending $ 38j,S.9,39;P.A.95-257,S.12,21,58.) final judgment is ordered held within seven days thereafter and provided further that 4 Story:P.A.77-614 replaced department of health will any persons so enjoined may make a written request to the court or judge issuing such 8 03 replaced public health council with commissioner 83;P.A.87-521 provided for the appointment of an auth< injunction for a hearing to vacate such injunction,in which event such hearing shall be n deleted reference to"quarantine"regulations re depart, held Within three days after such request is filed. = '93-381 replaced department and commissioner of heal d addiction services,effective July 1,1993;P.A.95-257 ddiction Services with Commissioner and Department of (d) In each town, except in a town having a city or borough within its limits,they' See Sec.19a-36 re Public Health Code. town director of health shall have and exercise all the power for preserving the public health and preventing the spread of diseases;and in an town within which there exists d.16 n to former section 19-80: p g p + Y ��_ Cited.166 C.337. - - a city or borough,the limits of which are not coterminous with the limits of such town; ` such town director of health shall exercise the powers and duties of his office only 1i' Sec. 19a-208. (Formerly Sec. 19-81 such part of such town as is outside the limits of such city or borough,except that when: nd district directors of health shall atter such city or borough has not appointed a director of health,the town director of health a blic Health to consider matters relating shall, for the purposes of this section, exercise the powers and duties of his office,---- cident to such attendance shall be paid by throughout the town,including such city or borough,until such city or borough appoints ? the director,provided said departments a director of health. �r y;- any year. r 7 �1949 Rev.,S.3851;P.A.77-598,S.4;77-614,S.323, (e) When such nuisance is abated or source of filth is removed from private property; History:P.A.77-598 added references to districts and d such abatement or removal shall be at the expense of the owner or occupant of such eaith with department of health services,effective Januar} property,or both,and damages for such abatement or removal may be recovered against 3381 replaced department of health services with depart them by the town,city or borough in a civil action as provided in a subsection(b)or in 9 3;P.A.95-257 replaced Commissioner and Departmen epartment of Public Health,effective July 1,1995. separate civil action brought by the director of health or any official of such city,tow-` D or borough authorized to institute civil actions. ,r r Sec. 19a-209. (Formerly Sec. 19-83 (1949 Rev.,S.3850;1959,P.A.445;P.A.77-465;P.A.87-521,S.2.) ver streams.The director of health of a to History:1959 act added provision for director of health authorizing qualified person to act;P.A.77-465 placed prevtotis" I body of water which is not wholly wit provisions in Subsecs.(a)and(d)and added new provisions in Subsecs.(b),(c)and(e)clarifying general provisions re all, in the enforcement of the laws, rul, maintaining nuisance or source of filth injurious to public health stated in Subsee.(a)and added exception in Subsea(� VO jurisdiction Over SUCK stream Or bod' re town health director's jurisdiction in cities or boroughs lacking health directors of their own;Sec.19-79 transferred Sec.19a-206 in 1983;P.A.87-521 amended Subsee.(a)to provide for the delegation of duties to an authorized agent and -1949 Rev.,S.3853.) a sanitarian and to make technical changes. History:Sec.19-83 transferred to Sec.19a-209 in 1983 See Sec.21 a-62 re power of local health authority to order analyses of foods and medicines or other articles for hurnan- nnotation to former section 19-83: consumption. See`note to section 19-79(19a-206)in re powers of sela i WELL-BEING Title 19a Ch. 368e .MUNICIPAL HEALTH AUTHORITIES 943 1, Shall be subject t0 a Civil penalty p:` See Sec.26-192g re duties of local directors of health with regard to unauthorized taking of shellfish in contaminated or posted areas. tch nuisance is maintained or such filt Annotations to former section 19-79: .rector in his order has expired, excep Towns not liable for acts of health officers,acting in good faith,and doing no unnecessary damage.Health officer is ly part thereof on Which a public eating. not liable for error of judgment when acting in good faith.51 C.93-102.No distinction between nuisances and filth as to rovisions of this subdivision, but shall power of health officer.Id.,98,99.Filth and nuisances may be removed although not endangering health at time of removal. Id.,102.Duty to prevent spread of disease.86 C.677.A person cannot be charged with a crime under this section until SUCK Civil penalty may be Collected i11'.. the time allowed in an order for compliance with its terms has expired.148 C.439.Cited.170 C.387;Id.,675. y Official Of SUCK tOWri,City Or borough First selectmen of towns have never possessed any authority concerning matters affecting the public health.8 CS 431. a able to the treasurer Of such Clt'', History and purpose discussed;the nuisances referred to are confined to those injurious to public health.24 CS 242. ' P y y,- Annotations to present section: tnt of such property, or both, shall be Cited.42 CA 631. a-220 and 19a-230. Sec. 19a-207. (Formerly Sec. 19-80). Duties of local officials. Emergencies. unctive relief seeking the abatement 30 Regulations.The local director of health or his authorized agent or the board of health ance of which is of so serious a nature shall enforce or assist in the enforcement of the Public Health Code and such regulations alth of persons other than the persons as may be adopted by the Commissioner of Public Health.Towns,cities and boroughs to a verified complaint stating the fac` may retain the power to adopt,by ordinance,sanitary rules and regulations,but no such t ex parte injunction requiring the abate= rule or regulation shall be inconsistent with the Public Health Code as adopted by said ilth and restraining and prohibiting t}> commissioner. In any emergency when the health of any locality is menaced or when r,and for a hearing on an order to sho any local board of health or director of health fails to comply with recommendations of continued pending final determtnatio the Department of Public Health,said department may enforce such regulations as may tat an immediate hazard to the heal6zo = be required for the protection of the public health. iuch nuisance Or Source of filth exis - (1949 Rev.,S.3806;1957,P.A.13,S.84;P.A.77-614,S.323,610;P.A.78-303,S.65,136;P.A.87-521,S.3;P.A. A a hearing on its continuance pending- 93-381,S.9,39;P.A.95-257,S.12,21,58.) Lys thereafter and provided further that: History:P.A.77-614 replaced department of health with department of health services,effective January 1,1979;P.A. s 78-303 replaced public health council with commissioner of health services;Sec. 19-80 transferred to See.19a-207 in quest to the court Or judge issuing suc 1983;P.A.87-521 provided for the appointment of an authorized agent to perform the duties of the local director of health )n,In which event Such hearing Shall be` and deleted reference to"quarantine"regulations re department's enforcement of regulations to protect the public health; d P.A.93-381 replaced department and commissioner of health services with department and commissioner of public health and addiction services,effective July 1,1993;P.A.95-257 replaced Commissioner and Department of Public Health and ` Addiction Services with Commissioner and Department of Public Health,effective July 1,1995. a cityborough within its limits,the or g See Sec.19a-36 re Public Health Code. all-the power for preserving the public Annotation to former section 19-80: d,in any town within which there exis€s Cited.166 C.337. iterminous with the limits Of such town powers and duties of his Office only i Sec. 19a-208. (Formerly Sec. 19-81).Health conferences.Town,city,borough f such city or borough,except that whe and district directors of health shall attend conferences called by the Department of or of health,the town director of healCh Public Health to consider matters relating to public health,and the necessary expenses se the powers and duties of his office incident to such attendance shall be paid by the town,city,borough or district represented )ugh,until such city or borough appoin_: by the director,provided said department shall not call more than two such conferences in any year. (1949 Rev.,S.3851;P.A.77-598,S.4;77-614,S.323,610;P.A.93-381,S.9,39;P.A.95-257,S.12,21,58.) Df filth is removed from private prope History:P.A.77-598 added references to districts and district directors of health;P.A.77-614 replaced department of )enSe of the Owner Or Occupant Of s--0. health with department of health services,effective January 1,1979;Sec.19-81 transferred to Sec.I9a-208 in 1983;P.A. eht or removal may be recovered agains 93-381 replaced department of health services with department of public health and addiction services,effective July 1, 1993;P.A.95-257 replaced Commissioner and Department of Public Health and Addiction Services with Commissioner ion as provided in subsection(b)or-# and Department of Public Health,effective July 1,1995. health or any official of such city,tow Sec. 19a-209. (Formerly Sec. 19-83). Jurisdiction of local director of health over streams.The director of health of a town,city or borough contiguous to any stream S1,s.2.> or body of water which is not wholly within the limits of such town, city or borough zing secs.qualified person to act;P.A.frog g465 placed prevtou Shall in the enforcement of the laws, rules and regulations relating to public health, lubsecs.(b),(c)and(e)clarifying general provisions . stated in Subsec.(a)and added exception in Subsee z( have jurisdiction over such stream or body of water and the islands situated therein. �. health directors of their own;Sec.19-79 transferred (1949 Rev.,S.3853.) le for the delegation of duties to an authorized ag.. i i History:Sec.19-83 transferred to Sec.19a-209 in 1983. dyses of foods and medicines or other articles forhu �;;Annotation to former section 19-83: See note to section 19-79(19a-206)in re powers of selectmen regarding public health.8 CS 431. -t - - ..---_.__ li _ �---- Noy ICE Z,pQ f�. 1( I; a. 3 F"Y`1 Lf ~� I i ii 1� I' i' I� �I 2005 Napping Fair Food Vendors ail nk1-P4kafd Better Bites&Beverages—Judith Snyder— 10 Kibbe Dr., Somers, CT 860-749-5411 Coffees, Tea, Juice,IN s, Biscotti's, Cookies, Danish., Cakes, Brownies Bobby T's—Bob Turcotte—PO Box 1516, Manchester, CT 860-643-1834 (2 BBQ Pulled Pork Sandwich, Pulled Chicken Sandwich, Soda,Water Campions Pizza—Campion—465 Buckland Rd, South Windsor, CT 860-648-9523 r Meatball Grinders Ak+ M- Dominos—Neil Warren—855 Sullivan Ave, South Windsor, CT 860-487-0077 Pizza, Breadsticks, cheesy Bread, Soda i eJW vkeyJ Harvest Hill Kitchens—Sandy Dziadul—72 Maple St,Ellington, CT 860-872-3807 Harvest Soup, Corn Chowder, Baked Potato, Com on Cob,Kielbasa, Chili, Sour Krout, Tossed Salad, Fruit Bowl, Yogurt, Apples, Scrambled Eggs, Toast,Home fries,Bacon, Sausage, Coffee, Tea, Hot Chocolate, Soda,Water, Juice Hillside Sweet House—Peter Ligas— 19 Main Street,East Haddam, CT 860-873-9284 Fresh Fudge,`Pucker Powder,L Rock Candy, ids Candy, Roasted Nuts SW Jaycees Food Tent—Paul Petrillo—PO Box 486, South Windsor, CT 860-573-6780 Hot dogs, Hamburgers, Cheeseburgers, Chili, Chips, Pickles, Soda, Water, Juice Specialty Beverage—Bob Cohen— 18 Deepwood Drive, Madison, CT 203-887-5990 Gourmet Coffees, Smoothies,,Lemonade, Ice Tea,Water w 2aC.PZ Y �1h6 1-�-1 tCr��y�f Oa, ✓3_c� t& a � �� 12d wove�d�� � ��• `L(4 241[7 `4 ot i SY T ce ct-leak- Zv CP f� - — -- ------- �l� �- SIP 11 dj i � . w Fat rFd- Fe VG 0 LS 1� k4. 1-cc L•����11 r bf 1 � � s Fm e; c eo l pop �� 10- -vy*0 r an.�1 _� J41 i �{I i c-4 ere? ge j �i oo 57blo :j i C 2 � 7 ' w 1 r �l b'b� S p crr� ro v r Z®3 v a V 36G ,� nn ' i d-l9h Ow eo �'p�I u 1 it i r T I! 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