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TEMPORARY FOOD VENDOR'S APPLICATION Aft food vendors (Moth for profit and non-profit)are required to rotum a slgnnd and oomplolnd copy of this checkrist to the fesilval coordinator three(3)weeks prior to this everd Saturdays 1. 1.Name of Event: Downtown Tracy Farmers Market fmte(q, Year Round 2- The following is information about my organ izallorubusl nos s• Name of organtzabonJbuslness, Byanka's Food Address: 17447 Stone Collar Way Lathrop, CA 95330 Phono: ( 650 )722 - 627a Alternate:( � 3_ LW food to be sold or given to the public salsas, Chllaqutles, Chips, Tamales C d, 1 am providing food that Is ,iiOY prepared at home. 0 Yes ❑No ' V All food 15 prepared on-site or Is from approved aommencial facifiWs: ❑Yea❑ No Name of facility; Byankas Food Phone: 17447 Stone Collar Way L.athLrop, CA 95330 - '7 Address of facility_17447 5. 1 am providing a booth with the following:(to protect my unpN*aged food and rood-prepamWn areas from Kos. dust and the public) `1 C 1 E .1 F,A booth with wau a'nd celtrng oonstruded of either wood, canvas, plastic, similar mate6al and fine mesh fly screening, completely enclosing open food areas. It wil also have a Smooth and cleanable floor (concrate, asphalt, clean tarps and smooth wood are acceptable) and constructed to separate food and food preparabOn areas from the public. Cl Other(specify): Note: The only operations not required to provide enclosed booths are those which sell beverages from appnymd dispensers,or prepackaged foods from approved sources. 6. Approved water for drinklrlg.utensil and hand washing will be provided in my booth by the following methods: ®Approved bottled water. ❑On-site hose bib that Is connected to a potable water source, ❑Other(specify); 7. Electriaty is provided for my booth's use:❑ Yes ❑No S I am providing an accurate probe thermometer to measure the hot and cold holding of potentially hazardous foods during all Ilmos of booth operation: ®Yes ❑ No 9. I am providing M following hot tomperuture control for the hot holding of all potentially hazardous foods above 135'F: ❑camp stove N/A ❑ 5temo a hotel trays ❑ Double steamer ❑Steam table& Inds ❑ Electric stovp lop ❑Other(specify) Note: Examples of potentially hazardous food include: meats, tamales. cooked beans, rice, vegetables,potato salad, eggs,and dairy products. U-0 lat2 ryC•7 CO 11 TE16P EVENT APP i