Laserfiche WebLink
TEMPORARY FOOD VENDOR’S APPLICATION <br />Year RoundDate(s):1. Name of Event: 1. <br />The following is information about my organization/business:2. <br />Wolfsens Me at & & usageName of organization/business: <br />358 South Ave, Gustine CA 95322Address: <br />881-6054( 209 )854-6456Phone:) <br />List food to be sold or given to the public:3. <br />4. <br />85 46456 <br />5. <br />N/A Other (specify): <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):N/A <br />Electricity is provided for my booth’s use: [3 Yes No7. <br />8. <br />9. <br />N/A <br />meats, tamales, cooked beans, rice, <br />Page 7 of 11 TEMP EVENT APPEHD 16-02 <br />08/01/16 <br /> A 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 />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 />I am providing a booth with the following: (to protect my unpackaged food and food-preparation areas from flies, <br />dust and the public) <br /> Sterno & hotel trays <br /> Steam table & lids <br /> Other (specify) <br /> Camp stove <br /> Double steamer <br /> Electric stove top <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 orior to this event <br />Weberstown Farmers Market <br />Note: Examples of potentially hazardous food include: <br />vegetables, potato salad, eggs, and dairy products. <br />I am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br />135°F: <br />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 0 No <br />_____________ Alternate: ( 510 <br />Various Sausages, Chicken, Steaks, Bacon, Salmon <br />I am providing food that is NOT prepared at home: 0 Yes No <br />All food is prepared on-site or is from approved commercial facilities: 0 Yes No <br />Name of facility: Wolfsens Meat & Sausage Phone:, 3^9) <br />Address of facility 358 South Ave, Gustine CA 95322