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TEMPORARY FOOD VENDOR'S APPLICATION <br /> All food ve4ndom (both for profit and non-profit) are required to return a s�Gned and camplolod copy of this chocklist to <br /> the festival coordinator three(3)weeks pear to this event_ <br /> Saturdays <br /> 1. l.Name of Event, Downtown Tracy Farmars Market oate(s): .Ycar Round <br /> 2. The follmving i5 Information about my organization,'twslnCss: <br /> Name of organ izatlonrbusiness• Fruity fa <br /> Address. 821 Kilarney Ct Lathrop, CA 95330 <br /> Phone: ( 209) Alternate: ( } — <br /> I List food to be sold or given to the public: Fruit Bowl, Fruit Salads <br /> 4, 1 am providing food that is NOT prepared at home: [Z Yes ❑ No <br /> Nt food is prepared on-site or Is from approved oommarcol facllities: ❑ Yes ❑ No <br /> Neat©of facility. Rhoce; { 1 <br /> Address of facility:- <br /> 5. lam providing a booth with the followir)g: (to protect my unpackzged food and food-preparation areas from flies, <br /> dustand the public) <br /> ® A booth v%ith wnlls and ceiling con5lrucled of a'cher vmod, canvas, piasbc, similar material and fine mesh fly <br /> screening, completely enclosing open food areas. It vrill aiso have a smooth rind cleanable floor (concrele, <br /> asphatL clean tarps and smooth WOW are adaptable) and oonstnpcted to scparatc food and food preparation <br /> areas from the public <br /> ❑Mar(specify): .N t 3 � - � - l - <br /> Noto: The only operations not required to provide enclosed booths are those which sell beverages frCxn <br /> approved dlspoa ors, or prepachagod foods from approved sources <br /> 6. Approved vratef for drinking, utensil and hand via5hing v,ill be provided In my booth by rho following methods: <br /> Approved bottled water <br /> ❑0n-site hose bib that is connnCed to a poiable water source. <br /> ❑Other(specify). - <br /> 7. Electriaty is provided for my booth's use: ❑ Yes❑ No <br /> S. I am providing an accurato probe thermometer to measure the hol rand cold hooding of potentially hanrdous <br /> foods during rill times of booth operation: CK Yes ❑ No <br /> �. I am providing the following hot iomperature control for rho hot holding of all potentially hazardous foods abovo <br /> 135`F- <br /> ❑ Camp stove NIA ❑ Storno& holes trays <br /> n Double simmer ❑ Steam table&lids <br /> ❑ Electric store top ❑01her(specify) <br /> Note, Examples of potentially hazardous food include: meats, tamales, cooked beans, rice, <br /> vegetables, potato salad, eggs, and dairy products. <br /> EFO iaC2 <br /> F'aj c I d I TFYP E_vr-14T APP <br />