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TEMPORARY FOOD VENDOR'S APPLICATION <br /> Alf food vendors (both for profit and non-profit) are required to return a signed and completed copy of this checklist to <br /> the Festival coordinator three(3)weeks prior to this event. <br /> - Saturdays <br /> 1. 1.Name of Event_ Downtown Tracy Farmers Market Date(s). Year Round <br /> 2. The following is information about my orWinlzat10n/busines5 <br /> Name of organization/business- �i �/') ��,�!'t Z/ <br /> Address: �[� LzejY zod A j76 <br /> Phone: ILC'� ) 32� / pAlter pate: {�0q <br /> 3. List food to be sold or given to the public; ��lZ'? fX.f �C1 U L <br /> 4. 1 am providing food that is NOTprepared at home: V1 Yes❑ No <br /> All food is prepare on-site or is from approved commercial facilities:f4 Yes❑ No <br /> Name of �- Phone: Z Z S=3z>' 7' <br /> Address of facility: V-4�� <br /> 5. 1 am providing a booth with the following: (to protect my unpackaged food and food-preparation areas from flies, <br /> dust and the public) <br /> A booth with walls and ceiling constructed of either wood, canvas, plastic, similar material and fine mesh fly <br /> Greening, completely enclosing open food areas. It will also have a smooth and cleanable floor (concrete, <br /> asphalt, clean tarps and smooth wood are acceptable) and constructed to separate food and food preparation <br /> areas from the public. <br /> ❑Other(specify). <br /> Notre: The only operations not required to provide enclosed booths are those which sell beverages from <br /> approved dispensers, or prepackaged foods from approved sources. <br /> 6. Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods: <br /> ❑ Approved bottled water. <br /> ❑ Ors-site hose bib that is connected to a potable water sourf <br /> }] Other(specify): <br /> 7. /Electricity is provided for my booth's use: ❑ Yes ] No <br /> B. I am providing an accurate probe thermometer to measure the hot and cold holding of potentially hazardous <br /> foods during all times of booth operation:'Yes ❑ No <br /> g. 1 am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br /> 1350F: <br /> N Camp stove ❑Stemo &hotel trays <br /> ❑ Double steamer ❑ Steam table &lids <br /> ❑ EleOric stove top ❑ Other(specify) <br /> Note: Examples of potentially hazardous food include: meats, tamales, cooked beans, rice, <br /> vegetables, potato salad, eggs, and dairy products, <br /> Earl 4-02 Pape 7 Of 11 ?F VP E o f 41 AP <br /> 0&01116 <br /> es <br />