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TEMPORARY FOOD VENDOR'S APPUCATION <br /> M food vendors (both for profit and non-profit)are required to return a signed and complatsd loopy of this chec lost to <br /> the festival coordinator three(3)weeks prior to thks event_ <br /> Downtown Tracy Saturdays <br /> 1_ 1.Name of Event cy Farmers Market Datn(s)_ Year Round <br /> 2. The following is infornnation about my organtzat orllbusiness- <br /> Name olorganizabonlbusiness: Queen B's Herbal Teas & More <br /> Aim: 1075 Came St Stockton, CA 95206 <br /> Phone: { 209 } Altercate: ( } <br /> 3 List food to be sold or given to the public: Herbal l eas <br /> 4. 1 am providing food that Is ILOT prepared at home:Q Yes C] No <br /> All food Is prepared on-site or Is from approved commercial fadlitles: ❑Yes ❑ No <br /> Na►n©of facility. Dueen El's Herbal Teas R Mora Rhona: <br /> Address of fadldy. T075 Carrie St Stockton, CA 95206 <br /> 5. 1 am providing a booth with the following:(to protect my unpackaged food and foo"reparabon areas from flies, <br /> dust and the public) <br /> ❑ A booth %mth walls and ca"g con.Siructed of edher wood, canvas, plastic, similar material and Fine mush fly <br /> screening, completely endosing open food areas. It will also have a smooth and cbanable floor (concrete, <br /> asphalt. clean tarps and smooth wood are acceptable) and constructed to separate food and food preparation <br /> areas from the public. <br /> ® other(specify): NIA Prepackaged Goods <br /> Note: The only operations not required to provide enclosed booths are those which sell beveragoa from <br /> approved dispensers,or prepackaged foods from approved sources. <br /> 6, Approved water for drinking,utensil and hand washing wid be provided In my booth by the folbwirg methods: <br /> ❑Approved bottlod water, <br /> ❑ On-slta hose bib that is connected to a potable water source. <br /> ®other(spedfy): NIA Prepackaged Goods <br /> 7 l=lectrldly Is proMed for my booth's use: ❑Yes ❑No <br /> 8. 1 am providing an accurate probe thermometer to measure tho hot and cold holding of potentially hazardous <br /> foods during all times of booth operation ❑ Yes❑ No <br /> b, 1 am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br /> 135'F: <br /> ❑Camp stove !1 N/A ❑ Stomo&hotel trays <br /> El Double steamer I V ❑Steam table S D ds <br /> ❑ Eledric stove top ❑Other(spay) <br /> Note: Examples of potentially hazardous food Include: meats, tamales, cooked beans. rice, <br /> vegetables, potato salad,eggs,and dairy products. <br /> EHo I6_C2 Page 7a111 <br /> CbDt IA 1EMP EVENT APP <br />