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TEMPORARY FOOD VENDOR'S APPLICATION <br /> Alt food vendors (both for profit and non-praFt)are required to return a signed and completed copy of this checklist to <br /> the festival coordinator throe (3)weeks prior to this event. Saturdays <br /> 1. 1.Name of Event Downtown Tracy Farmers Market i]ate(s): Year Round <br /> 2. The following is Information about my organizationlbusiness: <br /> Name of organizationtbusinesa_ Beckmann's Bakery <br /> Address: 1134 Bronson St#t6 Santa Cruz CA 95062 <br /> Phone: (831 ) 423-9242 Alternate:i, ) <br /> 3. List food to be sold or given to the public: Prepackaged non-Potentially hazard baked goods <br /> 4. 1 am providng food that is NOT prepared at home: JZ Yes❑ No <br /> All food is prepared ors-silo or is from approved commercial facilities: ❑ Yes❑ No <br /> Name of facility. Beckmann's Bakery Phone: --- <br /> Addsoss of facilty: 104 8 mnson St#16 Santa Graz CA 95062 <br /> 5, 1 am providing a booth with the fotlo%ving: (to protect my unpackaged food and food-preparation areas from flies, <br /> dust and the public) <br /> ❑ A boon with walls and ceiling constructed of either wood, canvas• plastic, slmilar material and fine mash fly <br /> screening, completety enclosing open food areas. It will also have a smooth and cleanable floor (concrete, <br /> asphalt, clean tarps and smooth wood are a=ptable) and constructed to separate food and food preparation <br /> areas from Ills public <br /> Other(6peaiy): WA Prepackaged GOodS <br /> Note: The only operations not required to provide endosed booths are those which sell beverages from <br /> approved dispensers, or prepackaged foods from approved sources. <br /> 8- Appruvod water for drinking,utensil and hand washlr►g MI be provided In my booth by the following methods; <br /> ®Approved bottled water. <br /> ❑ On-site hose bib that is connected to n potable water source. <br /> ❑Other(specify): . <br /> 7. Electricity ks provided for my boath'e uw: ❑Yes❑ No <br /> a. I am providing an accurate probe therrnornroter to measura the hot and cold Folding of potentially hazardous <br /> foods during all times of boob opmbw: (§Yes ❑No <br /> 9_ I am providing eha following hot temperature control for tho hot holding of all potentially hazardous foods above <br /> 135'F- <br /> ❑cramp stove N/A ❑ Stemo"hotel trays <br /> ❑ Double steamer ❑ Stoarn table&lids <br /> ❑ Elaclrlc stove top ❑Other(specify) <br /> Nate: Examples of potentially hazardous food Include: meats, tamales, cooked beans, rice, <br /> vegetables,potato salad, eggs,and dalry products_ <br /> Eft:]1E-02 Pxrp 7 Co.11 FE*.P EVENT APP <br />