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TEMPORARY FOOD VENDOR'S APPLICATION Ail food vendors (both for profit and non-profit)am required to velum a signed and completed copy of this checkkst to the festival coordinator three(3)wooks prior to this event-1. 1.Nae of w Saturdaysent Downtown Tracy Farmers Market DaBe(sk Year Round 2. The following is Information about my organlzationlbu5iness: Name of organlzatiowbusinass: Rosa's Portuguese Bakery Address: 2251 Jackson Ave Escalon, CA 95326 Phone. ( 209 )485 - 2943 _ Ntarnate: 3 List food to be sold or given to the public: Pastrfos and other baked goods 4 1 am providing food that is L prepared at home:10 Yes ❑No All food is prepared on-site or Is from approved commercial facifibes: ❑ Yes❑ No Name of facility: Rosa's Portuguese Bakery Phone: (209 1485-2943 Address of facility:2251 Jackson Ave Escalon, CA 95326 - - 5. l am providing a booth with the following: (to protect my unpackaged food and food-preparation areas from flies, dust and the public) Q A booth with walls and ceiling aonstrucind of either wood, canvas, plastic, similar material and fine mash fly screening, completely enclosing open food areas. It will akso have a smooth and cleanable floor (concrete, asphalt. dean tarps and smooth wood are acceptable) and constructed to separate food and food preparation areas from the public ❑Other(spoclty): Note; Tho only operatlons not roquired to provide endosed booths Are those whlch sefi beverages from approved dispensers,or prepackaged foods from approved sources. 6. Approved water for dmidng, utensil and hand washing will be provided In my booth by ft folkmUng methods_ ®Approved bottled water, ❑On-site hose bib that is connected to a potabl©water 5owue. ❑Other(specify): 7. Electricity is provided for my booth's use- ❑Yes ❑ No 8_ I am providing an accurate probe therrnomatnr to measure rho hot and cold holdng of potentially hazardous foods during all was of booth operation:0 Yes❑No 9. 1 am providing rho failovrirng hot temperatvro control for the hot holding of all polentisily hazardous foods above 135`F: ❑Camp stove N/A ❑ Stemo& hotel trays El Double steamer ❑ Steam table d lids ❑Eieciric stove top ❑Other(specify) Note: Examples of potentially hazardaus food Include: meats, tamales, cooked beans, rice, vegetables, potato salad,eggs, and dairy products. Qa 1e.02 Nge 7 d 1 t rE16p FVENT µPp ceaotM J