TEMPORARY FOOD EVENT PERMIT APPLICATION ...

Mailing Address: ______________________________________________________________City: ______________________________ State: ____________________ ZIP: ____________Home Phone: ____________________________ Daytime Phone: _______________________Email Address: ________________________________________________________________6. Please complete the table and initial each item on the Temporary Food Service Checklist.All Food Items Food Source Location Where FoodWill be PreparedDate & Time of FoodPreparationExample:HamburgersKroger Deli On Site 5/1/2012 3:00 pmTemporary Food Service Checklist** Please read the following and initial on the line provided to the right of each statement below. Someitems may not be applicable to your temporary food event. Please contact EHS with questions.**InitialsFood and ice must be obtained from an approved source. Receipts may be required.All food must be prepared on site or in an approved kitchen that is inspected byregulatory authorities. Home prepared food will not be allowed for service withthe exception of non-potentially hazardous baked goods prepared at home withprior authorization from the ISU EHS. Proper scoops must be used for dispensingice.Adequate cold holding equipment must be provided to maintain potentially hazardouscold foods at 41 0 F or below. Mechanical refrigeration is strongly recommended for alltemporary food events.Adequate hot holding equipment (electric or gas, or other approved equipment) mustbe provided to maintain potentially hazardous hot food at 135 0 F or above.