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TEMPORARY FOOD VENDOR'S APPLICATION <br /> All food vendors (both for pruFit and non-proflt)am required to return a signed and eompteted copy of this checklist to <br /> the festival 000rdlnalor three (3)wooks prior to this everit <br /> Saturdays <br /> 1. 1,Name of Event Downtown Tracy Farmers Market pate($}- Year Round <br /> 2, The following is information about my organizationUsfness: <br /> Name of organL&AtianlbLmMss: '}C's Holey Donuts <br /> Address: 616 Eileen Street Brentwood CA 94513 <br /> Phone: ( 925 ) 999 - 5835 Alternate: ( } <br /> 3. LWfood to be sold or given to the public: Mini Donuts. Milk, Water <br /> 4, 1 am providing food that is NOT prepared eft home:JZ Yes❑ No <br /> All food is propared on-site or Is from approved commercial facilities: ❑ Yes❑ No <br /> Name of facility. MJ's Dowtown Cafo _ Phone: (925 266 -0107 <br /> Address of facllAy:855 First Stroot Brentwood, CA 94513 <br /> 5. 1 Fun providing a booth with the following: (to protect my unpackaged food and food-preparation areas from lies, <br /> dust and the public) <br /> A booth with walls and caking constricted of either wood, canvas, plMlIc, similar material and fine mash fly <br /> rcreenthg, completely enclosing open food areas. It will also have a smooth and cleanable floor {concrete, <br /> ospbalL dean tarps and smooth wood are acceptable) and constructed to separate food and food preparation <br /> ­broas from the publlc. <br /> ❑other(specify): -- - <br /> Note: The only operations not required io provide enclosed booths are Lhasa which sell beverages from <br /> approved dispensers,or prepackaged foods from approved sources. <br /> B. Approved water for drinking,utensil and hand washing W1 be provided in my booth by the following methods <br /> ®Approved bottled water. <br /> ❑ On-alto hoso bib that is connected to a potable water source. <br /> ❑ Other(speclfy): <br /> 7. Electricity is provided for my booth's uso:❑ Yes [ No <br /> 8. 1 am providing an accurate probe thermometer to measure the hot and cold holding of potentially hazardous <br /> foods during art times of booth opembon- H Yes ❑No <br /> 9, 1 Fun providing this following? hot temperature control for the hot holding of all potentially hazardous foods above <br /> 135'F: <br /> ❑Camp stove NIA ❑ 5temo a hotel trays <br /> ❑Double steamer ❑ Steam table&lids <br /> ❑ Electric stove by l] Other(specify) <br /> Note: Examples of potentially hazardous food Include: meats, tamales. cooked beans, rice, <br /> vegetables,potato salad, eggs,and dairy products. <br /> r3-0 Ia-[1 Pap 7 air I I iUP EvEvr APP <br /> OW01Ito <br />