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TEMPORARY FOOD VENDOR'S APPLICATION <br /> All food Vendors(both for profit and non-profit)aie required to retum a signed and completed <br /> the festival coordinator three(3)weeks g Pleted copy of this checklist to <br /> poor to this event <br /> 1. 1.Name Saturdays <br /> �Event�Qwntown Tracy Farmers Market <br /> Date(s);�r round <br /> 2. The following is information about my <br /> Name of organ izebonlbusiness: <br /> Address: <br /> Phone: } _ <br /> Alternate:(530 ) <br /> 3 List food to be sold or given tO the public: ,cLmA ~y <br /> 4• 1 am providing food that is NOT prepared at home: ❑Yes J�rNo <br /> All food is prepared on-site or is from approved commercial facilities, ❑Yes®No <br /> Name of facility: I <br /> Phone: <br /> Address of facility: I t,\ <br /> 5. lam providing a booth with the following (to protect my unpackaged food and food-preparation <br /> dust and the public) pr paration areas from dies, <br /> 1 � <br /> ❑ A booth with walls and ceiling constructed of either wood,canvas, plastic, similar material and fine mesh fly <br /> screening, completely enclosing open food areas. It will also have a smooth and cleanable 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). <br /> Note: The only operations not required to provide enclosed booths are those which sell beverages from <br /> approved dispensers, or prepackaged foods from approved sources. <br /> & Approved water for drinking. utensil and hand washing will be provided 1n my booth by the following methods: <br /> Approved bottled water. �f <br /> ❑ On-site hose bib that is connected to a potable water source <br /> ❑ Other{specify}: - <br /> 7 EIWIlcity is provided for my booth's use El Yes�No <br /> an accurate probe thermometer to sure the hot and cold holding of potentially hazardous <br /> 8 ( am providing ation ❑Yes No <br /> foods during all times of booth oper <br /> win hot temperature control for the hot holding of all potentially hazardous foods above <br /> g I am Providing }the following <br /> 135`F: ti� ❑ Stern & hotel trays <br /> ❑ Camp stove ❑ Steam table&lids <br /> ❑ Double steamer ❑ Omer(specify) ccj� <br /> ❑ Electric stove tophaz2 <br /> ten a�Y fo <br /> �g,, a" ,� "ngde: meata, tamals�, cooked henna, rice, <br /> Note: Ue9 (Ies, 00 sa <br /> TEMP EVENT APP <br /> p,q,7or11 <br />