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TEMPORARY FOOD VENDOR’S APPLICATION Weberstown Farmers MarketI.Name of Event:1. The following is information about my organization/business:2. Naan Tikka Address: ( 916 ) 6203672Phone: List food to be sold or given to the public:3. 4. 5. Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods:6. Approved bottled water. On-site hose bib that is connected to a potable water source. n/a Other (specify): Electricity is provided for my booth’s use: Yes [3 No7. 8. 9. meats, tamales, cooked beans, rice, TEMP EVENT APPPage 7 of 11EHD 16-02 08/01/16 A booth with walls and ceiling constructed of either wood, canvas, plastic, similar material and fine mesh fly screening, completely enclosing open food areas. It will also have a smooth and cleanable floor (concrete, asphalt, clean tarps and smooth wood are acceptable) and constructed to separate food and food preparation areas from the public. Other (specify): N/A Name of organization/business: 2014 Del Paso Blvd, Sacramento, CA 95815 I am providing a booth with the following: (to protect my unpackaged food and food-preparation areas from flies, dust and the public) Note: 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 an accurate probe thermometer to measure the hot and cold holding of potentially hazardous foods during all times of booth operation: Yes No Camp stove Double steamer Electric stove top Sterno & hotel trays Steam table & lids Other (specify) _________ Alternate: ( ) Chicken Tikka Masala, Chicken Samosa, Chicken Curry, Palak Paneer,Eggplant Burani, Channa Masala, Daal Curry (Lenthal), Gulab Jamun, naan All food vendors (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. Note: Examples of potentially hazardous food include: vegetables, potato salad, eggs, and dairy products. I am providing the following hot temperature control for the hot holding of all potentially hazardous foods above 135°F: Date(s)' Sundays Year Round I am providing food that is NOT prepared at home: Yes 0 No All food is prepared on-site or is from approved commercial facilities: 0 Yes No Name of facility: Burly's Beverages Phone: (916 )6203672 Address of facility: 2014 Del Paso Blvd, Sacramento, CA 95815