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TEMPORARY FOOD VENDOR'S APPLICATION All food vendors (both for profit and non-profit) are required to return n signed and completed copy of this checklist to the festival coordinator three(3)weeks prior to thls event- Downtown Tracy 1. 1.Nsvr�o of Event: cy Farmers Market Saturdays Date(5). Year Round 2 The following is information about my organ lratlonAbusiness: Name of organizatlonlbusincss. The Brew t_o Address: 19829 A1dor Ave Tracy, CA 95304 Phone: { 209 )346 -_6324 Alternate: ( ) 3_ List food to be sold or given to the public: COfTee 4. 1 am providing food that is NOT prepared at home: ® Yes❑ No AIl food Is prepared on-site or Is from approved commercial facIld s ®Yes ❑ No Name of facility: Phone:L ) Address of facility: 5. 1 am pruviding a booth with the following- (to protect my unpackaged food and food-preparatlon areas from Eves, -st and the public) ®A bolath with walls and ceiling constructed of eithef wood, canvas, plastic, Sir WOF materlat and fine mesh fly sere Ing, completely enclosing open food areas. It will also have a smooth and cleanable floor (concrete, asphalt, clean tarps and smooth wood are acceptable) and constructed to separate food and food preparation areas from the public. 1 ❑ 00ef(spay): �, 1 C.� NA Note: The only ope fation5 not required to provide enclosed boo0ts are those which gall boverages from approved dispensers, or prepackaged foods from approved sources. $. Approved water for drinking,utensil and hand washing will be provided in my booth by the following methods' CR Approved bottled water. ❑ On-slta hose bib that Is connected to a potable water source. ❑Other(specify): 7. Boctriclty Is provided for my booth's use: ❑ Yes (]No 9_ 1 am providing an accurate prone thermo netor to measure the hot and cold holding of potentially hazardous foods during all times of booth operation: ® Yes❑No 9 1 am providing the following hot le rnperature control for the hot holding of all potentially hazardous foods above 135'F: ❑Camp stove N/A ❑ Stemo&hotel trays ❑Double steamer ❑Steam table d lids ❑ Electric stove top ❑Other(spndfy) Nate: Examples of potentially hazardous food Include: meats, tamales, cooked beans, rice, vegetables,potato salad. eggs,and dairy products. FH tM02 P�7 ar 11 TEW EVE1 I APP "