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TEMPORARY FOOD VENDOR'S APPLICATION <br /> All food vendors (both for profit and non-profit) are requred to return a signed and completed copy of this c heckrtst to <br /> the festival coordinator three(3)weeks prior to this event_ Saturdays <br /> 1. 1.Name of£ventQq town Tracy Farmers Markel Data(s): (Year Round) <br /> 2 The following is information about my organization) <br /> business* Name of organizatlonAwsiness: lCuya's Cookies <br /> Address: 3255 Milton Jenson Way Tracy, CA 95377 <br /> Phone: ( 510 ) 512'5630 Memate: ( 51 p ) 512'S 117 <br /> 3. List food to b-a sold or given to the public Home made from Scratch cookies <br /> 4. 1 am providing food that Is NOT prepared at home_ ❑Yes®No <br /> All food Is preWned on-site or is from approved commercial facilldes: ❑ Yes E No <br /> Name of facildy. Phone: ( I <br /> Address of faciity:_ <br /> 5. l am providing a booth wtth the following: (to protect my unpackaged food and food-preparation areas from fails, <br /> dust and the public) <br /> ❑ A booth with walls and cuing constructed or either wood, canvas, plastic, similar material and fine mesh fty <br /> screening, completely encloslng open food areas. It will also have a smooth and cleanable floor (concrete, <br /> asphalt, clean tarps and smooth wood are ac ceptabta) and constructed to separate food and food preparation <br /> areas from the public. <br /> ❑ Other(specify): 1 l C <br /> Note: The only operations not required to provide unclosed booths are those v&Ich sell beverages from <br /> approved dfispensens, or prepackaged foods from approved souroes. <br /> 6. Approved water for drinking, utensil and hand washing will be provided in my booth by the following mothads: <br /> ❑Approved bottled water. <br /> ❑ On-site hose bib that Is connected to a potable water 5our>4e. <br /> D Other(specify): <br /> 7. FlIectrlcity Is provided for my booth's use: ❑Yes W Nis <br /> 8. 1 am providing an accurate probe thermornatef to measure the hot and cold holding of potentially hazardous <br /> foods during all times of booth operation: ❑ Yes® No <br /> 9. 1 am providnrog the following hot temperature control for the hat holding of all potondally hazardous foods above <br /> 135'F: <br /> ❑camp stove ❑ Stemo a hotel trays <br /> ❑Double steamer ❑ Steam tattle&lids <br /> ❑ Bect is stove top ❑ Other(specify) <br /> Note: Examples of potentially hazardous food Include: meats, tamales, cooked beans, rice, <br /> vegetables, potato salad, eggs,and dairy products. <br /> 0-0 111LT2 Pad.i�+„ MW EVENT rwP <br />