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TEMPORARY FOOD VENDOR'S APPLICATION All food vendors (both for profit and non-profit) are roqumed to return a signed and completed copy of this checklist to the festival coordlnator three(3)weeks prior to this event Downtown Tracy Farmers Market Saturdays 1. 1.flamo a[Event: Y Datc(s): Year Round 2 The fdlrnving is information about my organization�business: Name of organ lzation'business• Adri's Cookio Co. Address: 2325 Oregon Ave Stockton, CA 95204 Phone: ( 209 ) 471 - 5397 Alternate: ( ) 3 List food to be sold or given to thin public: Cookles, Cakes, Clnnamon Rolls, Cupcakes (mist. baked goods) 4. I am providing food that is NOT prepared at home: 91 Yes ❑ No All food Is prepared on-site or Is from approved commercial fadlibes: ❑Yes ❑ No Name of facirdy: Phone:l�L Address of facility.2325 Oregon Ave Stockton, CA 95204 5 1 am providing a booth with the following: (to protect my unpackaged food and food-preparabon areas from flies, dust and the public) ❑ A booth with walls and ceiling constructed of either wood, canvas, plastic, similar material and fine mesh fly screening, Completely enclosing open food afoas 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 ft public. iz Othef(spedfy): Nt Prepackaged Gaols Nola: Tho only operations not required to provide enclosed bodhs are tho:o which sell beverages from approved dispensers, or prepackaged foods from approved sources. B. Approved water for drinking, utonsil and hand washing will be provided in my booth by the following methods: ®Approved bottles! wafer. ❑ On-site hose bib that Is connected to a potable water sourre ❑ Other(specify): 7. Electricity Is provided for my booth's use: ❑ Yes ❑ No 8. 1 am providing an accurate probe thermometer to measure the hot and cold holding of potentially hazardous foods during 0 tirnas of booth operation: ® Yes❑No 9. I am provvdLng the fofloWing hot temperature controf for the hot molding of all potentially hazardous foods above 135'F: ❑Camp stove NIA ❑Stemo a hotel trays ❑ Double steamer ❑5toam table &lids ❑ Electric stove tap ❑011her(specfy) Note: Examples of potentially hazardous food include: meats, tamalos, cooked beans, rice, vegetables, potato salad, eggs,and dalry products. DID 10-07 rare 7e 11 TEt1PF%FNTAPP � 'xni na