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TEMPORARY FOOD VENDOR'S APPLICATION AM food vendors (both for profit Sind non-profit)are required to return a signed and completed copy of this chockJlsl to the festival coordinator three (3)weeks prior to this oven!_ 1. Downtown Tracy Saturdays i_Flamp of Event cy Farmers Market oate(5): Year Round 2. The fodawing Is lnformatlon about my organizaboWbuslness: Name of organizatiorubuslness; More TO Lffe Address: 1346 The Alam©da #257 San .dose, CA 95216 Rhone: ( 408 ? 600- 8275 Alternate: ( ) 3. List food to be sold or grvon to the publlr— Belgnets, Breakfast Burritos 4. 1 am prurvldIN food that is YM prepared at home: ❑( Yes❑No Al food is prepared on-silo or is from approved commorcAW facilities: ❑Yes❑ No Name of fadjoy. Greenleas Bakery Phone:L4ZO 460-4691 Address of fadlity: 1dt31 The Alameda San .lose, CA 95215 5. 1 am providing a booth with the following: (to protect my unpackaged food and faod•preparabon areas from fries, trust and the public) A\'booth with walls and c+elling construded of either wood, canvas, plastic, similar material and fine mash fly ing, Completely enclosing open food areas. It will also have a smooth and cleanable floor (ooncmto, hah. dean tarps and smooth wood are acceptable)and constructed to separate food and food preparation areas from the public. ❑Other(specify): Note: The ordy operations not required to provide enclosed booths are [hose which sell beverages from approved dispansers,or prepackaged foods from approved sources. 8. Approved water for drinking, utensl 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. Electricity Is provided for my booth's use:❑ Yes❑ No 8. 1 am providing an accurate probe thermometer to measure tho hit and cold holding of potentially hazardous foods during all times of booth operation- , ® Yes❑No 9. 1 am providing the following hot temperature control for ttx3 hot holding of all potentially hazardous foods above 135'F: ❑camp stove ❑Stamo b hotel trays ❑Double steamer ❑ Stearn table 8 lids ❑ Electric stove top Z Other(specify) Note: Exarnplaa of potentially hazardous food Include: meats, tamales, cooked beam, doe, vegetables, potato salad,eggs, and dairy products. E101"2 Page Dd+u ny p 1 E 1P EVENT APP l