Dd Form 2975 - Temporary Food Event Coordinator'S Application Page 2

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TEMPORARY FOOD EVENT COORDINATOR'S APPLICATION

11. Planned number of temporary food operations or concessions during this venue:

12. INDIVIDUALS RESPONSIBLE FOR EACH TEMPORARY FOOD OPERATION

a. Concession Name

b. Operator Name (first & last)

c. Address (include ZIP Code)

d. Phone (include area code)

13. Date and time food service operations will be set up:

14.a. Describe toilet and hand wash facilities that will be available onsite (type; number; location):

b. Who is responsible for toilet/hand wash facility

c. If portable toilets are used, how often will they be serviced during the event?

maintenance during the event? (name, organization, & phone)

(provide frequency, interval, or dates)

15. Will electricity be provided to temporary food establishment sites?

Yes*

* If Yes, describe how:

16. Describe the potable water supply available onsite (to support food concessions & hand wash):

Note: If a non-public water supply is to be used (i.e., well water), the results of the most recent water test must be submitted with this application.

17. Describe wastewater disposal system available onsite:

DD FORM 2975, NOV 2013

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