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I <br /> TEMPORARY FOOD VENDOR'S APPLICATION <br /> All 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 organ ization/business: <br /> Kristen's Cookies e -r D <br /> Name of organization/business: ,/ <br /> Address_ _13,-I 7 PI/0 {0 ROY f`�'1. P Sy b�� <br /> Phone: ( z 0 y ) 3?-f ^ g 3-3�a Alternate: (Pq <br /> 3. List food to be sold or given to the public: 0co 1*1e GDD 1'�f' <br /> 4. 1 am providing food that is NOT prepared at home: ❑ YesgNo <br /> Ai food is prepared on-site or is from approved commercial facilities: ❑ Yesz No <br /> Name of facility: _0 0" P ft+-eM Phone: (v19 <br /> Address of facility: 5191 Ptlrhon PV P-4- Tka ,7304 <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 /> 0 booth with walls and ceiling constructed of either wood, canvas, plastic, similar material and fine mesh fly <br /> screening, 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 /> Note: 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 /> ❑ On-site hose bib that is connected to a potable water source. <br /> ❑ Other(specify). <br /> 7. Electricity is provided for my booth's use: ❑YesoNo <br /> 8. 1 am providing an accurate probe thermometer to measure the hot and cold holding of potentially hazardous <br /> foods during all times of booth operation:oYes❑ No <br /> 9. 1 am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br /> 135°F: <br /> ❑Camp stove ❑ Stemo& hotel trays <br /> ❑ Double steamer ❑ Steam table &lids <br /> ❑ Electric 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 /> EHD 16-02 Fags 7 of 11 TEMP EVENT App <br /> OM1116 <br />