HomeMy WebLinkAboutTemp Food Correspondence 501503 Evergree VENDOR
APPLICATION
AND
QU IDELINES
FOR
TEMPORARY FOOD SERVICE: EVENTS
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VENDOR AIPPLWATioN FOR T'Emp'onARY rOOD EVENT
The VENDOR of each temporary food event roust 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 i to 5 days.
Today's Date 151 f t[Lot
Narxze of Event
- ►r'
Date of Event
Time of Event Gb:6D &4,V--T
Location of Event ' C LV LLL
Event Coordinator 1}Gb l 2etZ-!�vE tt lr
Event Coordinator Address �e t .L� �.�—W ) i'�' gro��`'fir L
Event Coordinator Phone# o - -
Event Coordinator E-Mail Address
Event Coordinator Phone#(cell,work&horne) '' l
Name of Applicant ' S �{ t
Name of Applicants Business(please indicate if mobile:vendor)._
Applicants Address I e.,� '[ t t Cz , . - - i 6z> so
Applicants E-Mail Address_ Y PAA.6tE1.0
Applicants Phone#(cell,work&home) 43 2--
Setup time b'4
Please provide the following: (If any of the following does not apply to you put NIA)
1.List all food and beverage items to be prepared and served(menu).Attach a separate sheet if
necessary.
NOTE: Any changes to the menu must be submitted to the Health Department 10 days prior to the
event.
2
2. Describe specifically how frozen, cold,and hat foods will be transported.to the event.
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 A.
5. Use attachment#2 i this packet to sketch a drawing s owing the event wea and w1here your
operation will be. e(.l A-4 -2-
6.Describe the number,location and set up of handwashing facilities to be used by employees.
c� (00- , to m cc.�;W (6. k
-�t Ck-V + f C,�L k/
7.Describe how and where utensiYequipmmnt washing will tape place. If no facilities are available,
describe how alternate steps will be taken.
lye V c r"
2
8.Describe how wastewater will be collected,stored and disposed.
escn e e Number and location of garbage containers.
l - aka Lf
10,Describe what heat source will be used to keep hot foods hot(140 degrees and above).,ttZ
11.Describe how colds foods will be kept:cold.(45 degrees and below).
12.Describe how food temperatures are monitored,cleaned and sanitized.
I a,
13.Will foods be prepared on situ I no,where will foods be purchased?(enclose copy of foo license)
3
NAIVI OF EIPLO EE PHONE,# ADDRESS SHIFT
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4.
5.
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7
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9,
10,
ATTACHMENT L2
CHECKLIST FOR FOOD BOOTH/VENDOR OPERATORS
Metal probe thermometer(0-22:0 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)
:V1 Plastic wrap/Aluminum foil
Extra utensils.;tongs,spatulas,spoons,and knives
Water source
Buckets/tubs for washing,rinsing,sanitizing food equipment
Y) Bleach for sanitizing,test strips for checking
Waste water disposal container
Y1 Gam° Containers).for grease collection
Glean wiping cloths and a container to store them in
Garbage containers and plastic bags
4
J
ats air restraints
Crates,shelves to store food riff of the ground
Moves for food handling
Hand washing station
5
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VENDOR
APPLICATION
AND
GUIDELINES
FOR
TEMPORARY FOOD SERVICE EVENTS
\\sthfile00 t\users\robertmdevito\Desktop\Temporary Food Vendor Application 2007.doe
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 t,9 l
Name of Event st rl:os
Date of Event '{_.,t LyS d.txA.l yU d-f<l
�—
Time of Event (a: Cb
Location of Event '� C l LA_, _ S� 1T6t�4
Event Coordinator tQ i CO rt_Pd,-Z.!SZQ�,il SJL J
Event Coordinator Address 45o t (5vtrq jr-ty,_ a! ,{'[u�e,_563 ';!t uT* W i tl01;4Qs 0
Event Coordinator Phone# SU 0•
Event Coordinator E-Mail Address _in
Event Coordinator Phone cell work&home)__Sle Q. bo X. �-1 15'7
Name of Applicant
Name of Applicants Business(please indicate if mobile vendor) 1 4-Q 115 6 vtA l...t,,
Applicants Address E �� A t_L'ize
Applicants E-Mail Address
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)
1.List all food and beverage items to be prepared and served(menu). Attach a separate sheet if
necessary.
NOTE: Any changes to the menu must be submitted to the Health Department 10 days prior to the
event.
2
2. Describe specifically how frozen, cold,and hot foods will be transported to the event.
C b u� bo t� Ta SJ in Co bu.O.
3. List all places(name&address) where meats,poultry,seafood, shellfish, and ice will be purchased.
n
4. List names,phone numbers, addresses, and shifts to be worked of all employees. See attachment#1.
5. Use attachment#2 in this packet to sketch a drawing showing the event area and where your
operation will be.
6. Describe the number, location and set up of handwashing facilities to be used by employees.
7. Describe how and where utensil/equipment washing will take place. If no facilities are available,
describe how alternate steps will be taken.
2
8. Describe how wastewater will be collected, stored and disposed.
�,t�'P- V � -t- d t'c j K W b S-t VI IL- ! VI
9. Describe the number and location of garbageJ ,,containe O�k
rs �+ j
10. Describe what heat source will be used to keep hot foods hot(140 degrees and above).
C It L_ -t-e CIaC) k- 4-6—1 �D b(I Isfi
11. Describe how colds foods will be kept cold(45 degrees and below).
12.Describe how food temperatures are monitored, cleaned and sanitized.
13. Will foods be prepared on site? If no,where will foods be purchased? (enclose copy of food license)
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)
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
e Waste water disposal container
Container(s)for grease collection
IClean wiping cloths and a container to store them in
Garbage containers and plastic bags
4
J` Hats/hair restraints
Crates,shelves to store food off of the ground
_Gloves for food handling
---Hand washing station
v
5
VENDOR APPLICATION FOR TEMPORARY FOOD EVENT
The VENDOR of each temporary food event must complete this application and must be filed 14 days
prior to the opening event. This application must be submitted to the Town of South Windsor
Health Department, 1540 Sullivan Avenue, South Windsor,CT 06074.
This application is not a Iicense.Temporary food permits will not exceed a period of 1 to 5 days.
Today's Date tv/3O/,U t i
Name of Event _`R L'Ut;V1_LU-Z4-� &X-n"Lk e G rl C.t..f � st ri
Date of Event t��d { ,t t �` 1 --f,
Time of Event (a: vt — f�f1 tcLty�
Location of Events
Event Coordinator tJ j Co Lk (,1,Ct.,ndy s U yj
Event Coordinator Address 45o i Gajq (A)tj i 4t LAe 56:� at u.-T* f r)Q�t�' � ��a-7`
Event Coordinator Phone# SU O. -.3
Event Coordinator E-Mail Address
Event Coordinator Phone ell work&home) S-4 b:
Name of Applicant
Name of Applicants Business(please indicate if mobile vendor) -b LtL►� GCf? Q�
Applicants Address e (W L' �I {-& t
Applicants E-Mail Address
Applicants Phone#(cell,work&home)
Setup time___ r`•
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.
2
2.Describe specifically how frozen, cold,and hot foods will be transported to the event.
,,b t✓J) -tom h t�) Cam{25-- -t '�:LCA-b5 y�i i. L,
eA CD
I Y1 d
I 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.
5. Use attachment#2 in this packet to sketch a drawing showing the event area and where your
operation will be.
6.Describe the number,location and set up of handwashing facilities to be used by employees.
C E) S+ ar � -t 4-a 4-
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.
W LA7-e--L O a-T4 4 W I L'L' tip GO LLt- Y1 r Y1
9.Describe the number and location of garbage cont, ers.
10.Describe what heat source will be used to keep hot foods hot(140 degrees and above).
Y)/ 0--
11. Describe how colds foods will be kept cold(45 degrees and below).
��t,l- Pftek -b S A.Y�-D Gt?e fh (t) t_.� Sop0-4 1 t rt CL-"_-
���o b L;'oz �'w� &I(- G� 1 e� Lb Cam--) t YI
12. Desc�w food temperatures are monitored,cleaned and sanitized.
13.Will foods be prepared on site?If no,where will foods be purchased? (enclose copy of food license)
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)
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
[X—Water source
Buckets/tubs for washing,rinsing, sanitizing food equipment
�n _— 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
4
e
Hats/hair restraints
Crates, shelves to store food off of the ground
x Gloves for food handling
l Hand washing station
-vc ce_ �
5
VENDOR
APPLICATION
AND
GUIDELINES
FOR
TEMPORARY FOOD SERVICE EVENTS
VENDOR APPLICATION FOR TEMPORARY FOOD EVENT
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: 5111/11
Name of Event: Paws on the Promenade—5/21/11. Rockville Bank Summer Concert Series—6/30/11,
7/28/11, 8/4/11, 8/18/11. Evergreen Walk Pictures in the Park—8/12/11, 8/19/11.
Date of Event: Dates listed above.
Time of Event: 4:O0pm to 10:00pm
Location of Event: Evergreen Walk, South Windsor
Event Coordinator: Elizabeth Maheu or Nicole Grendziszewski
Event Coordinator Address: 501 Evergreen Way, Suite 503 South Windsor, CT.
Event Coordinator Phone#(860)432-3398
Event Coordinator E-Mail Address: emaheu@pm-lifestyle.com or ngrend@pm-lifestyle.com
Event Coordinator Phone# (cell,work&home) (860) 423-3398
Name of Applicant: Mike Allen
Name of Applicants Business (please indicate if mobile vendor): Yukon Kettle Corn(operate under a
tent)
Applicants Address: 506 Ravenelle Road North Grosvenordale, CT. 06255
Applicants E-Mail Address: msallen518@yahoo.com
Applicants Phone# (cell,work&home): (860) 315-4248
Set up time: 2 hours before each event.
Please provide the following: (If any of the following does not apply to you put N/A)
1.List all food and beverage items to be prepared and served(menu). Attach a separate sheet if
necessary.
NOTE: Any changes to the menu must be submitted to the Health Department 10 days prior to the
event.
Kettle Corn Popcorn—popcorn cooked (popped)in a kettle.
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.
Owner operated
5. Use attachment#2 in this packet to sketch a drawing showing the event area and where your
operation will be.
See attached for booth set up. The events will be in the Rockville Bank park behind LL Bean.
6. Describe the number, location and set up of hand washing facilities to be used by employees.
One station in back of the booth area. It will consist of warm water in a container with a spout
and a catch bucket with a lid. I use liquid hand soap with sanitizer.
7. Describe how and where utensil/equipment washing will take place. If no facilities are available,
describe how alternate steps will be taken.
We have access to a commercial kitchen with a sanitizing sink. Our friends own a catering
business and allow us to use their facility.
8. Describe how wastewater will be collected, stored and disposed.
It is collected in a bucket that has a lid. It will be taken home each night and emptied.
9. Describe the number and location of garbage containers.
There is one 55 gallon garbage container located behind the booth.
10. Describe what heat source will be used to keep hot foods hot(140 degrees and above).
N/A
11. Describe how colds foods will be kept cold(45 degrees and below).
N/A
12. Describe how food temperatures are monitored.
N/A
license) y 1
Yes, all popcorn is prepared on site.
NAME OF EMPLOYEE PHONE# ADDRESS SHIFT
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
M
10'
Table for supplies
(popcorn,sugar,oil 0 Propane tank
and salt). Handwash
cta+inn
Rack to Propane
Kettle
display Cooker
bags of
10' packaged
kettle corn
popcorn.
Popcorn
receiving bin
Cashier's Table