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COMPLIANCE INFO_2025
Environmental Health - Public
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EHD Program Facility Records by Street Name
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1600 - Food Program
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PR0515040
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COMPLIANCE INFO_2025
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Entry Properties
Last modified
4/7/2026 4:35:56 PM
Creation date
4/7/2026 4:29:54 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2025
RECORD_ID
PR0515040
PE
1695 - TEMPORARY EVENT
FACILITY_ID
FA0006677
FACILITY_NAME
SJ CERT FARMERS MKT/DOWNTOWN TRACY
STREET_NUMBER
900
STREET_NAME
CENTRAL
STREET_TYPE
AVE
City
TRACY
Zip
95376
APN
23505517
CURRENT_STATUS
Active, billable
QC Status
Approved
Scanner
SJGOV\ymoreno
Supplemental fields
Site Address
CENTRAL AVE TRACY 95376
Tags
EHD - Public
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TEMPORARY FOOD VENDOR'S APPLICATION <br /> All food vendors(both for profd and non-profit) are regulred to return a signed and completed copy of this checklist to <br /> the festival coordinator threes(3)wooks prior to this event. <br /> Saturdays <br /> 1 1.Name of Event: Downtown Tracy Farmers Market Date(rq Year Round <br /> 2- The fodowmg Is Information about my organizatloWbusiness <br /> Name of organlzatimbusincss: Black Dragon Beverage Company <br /> Address- 1355 Lanker5hire Or <br /> Pleone. 925 1 961-2054 Anamate: (209 ) 346-8287 <br /> Vi©tnamese Coffoo. Cold Brew, Thal Tea, Chai Tea, Italian Crome <br /> 3. List food to be sold or given to the public: Soda Fizz Soda (Sugar F e Specialty Drinks hot/cold <br /> 4. I am providing food that is NOT prepared at home: 0 Yes ❑ No <br /> All rcM Ir proparwd on-site or is from appmvrd commercial taalltics: [] Yes❑ No <br /> game of fachAy. WA _ Phone: f l <br /> Address c!fac.•lity: WA <br /> 5. 1 am providing a booth wl:h tlr"a follOW-ng.(to protecz my ur.packaged food and food-prep=Uan areas from flies, <br /> dust and thte public) <br /> A hoat'e ti+ith >>a,ls arid ceding constructed of e'.he�r wood. canvas, pLnstic, similar <br /> material and fine mesh fly <br /> screiMr a. completely encloslr�g cpcn food areas I; .v+ll atw hav© a smooth and cleanable floor (concrate, <br /> aspt,ar,, clears tarps and 5mo4th v"ood we acceptab'e) and cons`•ructad to separate food and food preparatlon <br /> areas from the PL1201: <br /> ❑ aher(specrfy): _ <br /> Note: The only operarsers,o,Pfequlckag o f roods tram alpprnved sa res. those votlich nett beverages from: <br /> approved d•spA <br /> 6. Approved v+ater for drinking, utensil and har�a washing will be provided in my booth by the fotlrnvtng methods: <br /> Approved bOuled water. <br /> ❑ On-site hose bib that is connoc;ed to a potable water sourca. <br /> ❑ Othar (specify): <br /> 7. Ele3ctridty is provided for my ba01h'5 use. ®Ye5❑ Na <br /> 8. 1 am providing an ate probe lhermomc'.er to moasuro the hot and cold holding of potenUalty hazasdaus <br /> accurate <br /> foods during all times of booth o¢ <br /> erateort: DK Yes ❑No <br /> g. I am providing the tolSo4vin9 hot temperature control for the trot holding at NI potontialty hazetti�5 foods above <br /> 135'F: <br /> Camp stove ❑ 5tomo b hotel trays <br /> Double steamer ❑Stearn table 81id5 <br /> 0 Eettric stove too ❑Mel (5peafy) <br /> food include: meats, tamales, cooked Means" vice.es of p8tenti* ha.ZardoUS roduclu <br /> Note: tic ta eta salad"eggs,and dairy p <br /> vegetables,p� -- <br /> «Q EVE-1li r•PF <br /> P'7e t t1 <br /> Eli 1642 <br /> C�1CU1e5 i <br />
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