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TEMPORARY FOOD VENDOR’S APPLICATION All food vendors (both for profit and non-profit) 1.Date(s): 7-9-21 2. Address: Phone:( 209) 666-1570 401-2516Alternate: ( 3Q1 ) 3.List food to be sold or given to the public: Wings 4. 666-1570 245 East Eleventh Street Tracy, CA 95376 5. Note: 6. Electricity is provided for my booth’s use: E^es No7. 8. 9. Note:meats, tamales, cooked beans, rice, Page 7 of 11 TEMP EVENT APP Camp stove Double steamer Electric stove top On-site hose bib that is connected to a potable water source. Esther (specify): Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods: ©"Approved bottled water. EHD 16-02 11/4/14 I am providing food that is NOT prepared at home: Yes No All food is prepared on-site or is from approved commercial facilities: Yes No Name of facility: Winn Ya rd _________________________Phone: ( 209) Address of facility: 245 East Eleventh Street Tracy, CA 95376 The only operations not required to provide enclosed booths are those which sell beverages from approved dispensers, or prepackaged foods from approved sources. I am providing a booth with the following: (to protect my unpackaged food and food-preparation areas from flies, dust and the public) S^booth with walls and ceiling constructed of either wood, canvas, plastic, similar material and fine mesh fly screer ing, completely enclosing open food areas. It will also have a smooth and cleanable floor (concrete, aspha t, clean tarps and smooth wood are acceptable) and constructed to separate food and food preparation areas from the public. Other (specify):___ _______________________ ______________________ I am providing the following hot temperature control for the hot holding of all potentially hazardous foods above B^terno & hotel trays Steam table & lids a^fHer (specify) kWt-OG Examples of potentially hazardous food include: vegetables, potato salad, eggs, and dairy products. , . | ■ . ) are required to return a signed and completed copy of this checklist to the festival Coordinator three (3) weeks prior to this event. 1. Narpe of Event: Downtown Tracy Block Party The following is information about my organization/business: Name of organization/business: WingYard___________ 245 East Eleventh St Tracy, CA 95376 I am providing an accurate probe thermometerjto measure the hot and cold holding of potentially hazardous foods during all times of booth operation: BYes No