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� 1 TEMPORARY FOOD VENDOR'S APPLICATION All food vendol5 (both for profit and non-profit) are required to return a signed and completed copy of this checklist to the festival coordinator three (3)weeks prior to this event. Saturdays 1. 1.Name of Event:_ Downtown Tracy Farmers Market Date(s): Year round 2, The following is information about my organization business: !Name of organization/business: l I 0 o 1 CL Address: Cr�1 GI r C-)"A r c,^1��l v 0 �� l Phone: (� 011) V) ! 7 Z q Ailemate: ( ) 3- List food to be sold or given to the public: f_Ut'l S1 s t S E 1 Gt C1 4. 1 am providing food that is NOT prepared at home: V3 Yes❑No All food is prepared on-site or is from approved commercial facilities:W Yes❑No Name of facility: Phone: Address of facility: 5• 1 am providing a booth with the following: (to protect my unpackaged food and food-preparation areas from flies, dust and the public) 14 A booth with walls and ceiling constructed of either wood, canvas, plastic, similar material and fine mesh fly peening, completely enclosing open food areas. It will also have a smooth and deanable floor (concrete, asphatl, clean tarps and smooth wood are acceptable) and aonstn}cted to separate food and food preparation areas From the public- ❑Other(specify): Note: The only operations not required to provide endosed booths are those which sell beverages from approved dispensers, or prepackaged foods from approved sources. 6. Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods: qApproved bottled water. ❑On-site hose bib that is connected to a potable water source. ❑Other(specify): 7. Electricity is provided for rry booth's use: ❑Yesyd,No 8- 1 am providing an accurate probe thermometer to measure the hot and cold holding of potentially hazardous foods during all times of booth operation Yes❑No 9. 1 am providing the following hot temperature control for the hot holding of all potentially hazardous foods above 4135°F: ❑Camp stove ❑Stemo 3 hotel trays ❑Double steam' ❑Steam table 3 lids ❑Electric stove top ❑Other(Specify) Note: Examples of potenWRy hazardous food include: meats, tamales, cooked beams, rice vegetables,potato salad,eggs,and dishy products. E"D 1"2 gage 7 of 11 1EbP EVEMY 0&01116