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TEMPORARY FOOD VENDOR'S APPLICATION <br /> AN food vendors (both for profit and non-profit) are required to return a signed and comple;ed copy of this checklist to <br /> the festival coordinator three (3)vmoks prior to this event <br /> Saturdays <br /> 1, 1.Name of Event: Downtown Tracy Farmers Market Date(s): Year Round <br /> 2, The following is inforrrlalion about my organtra5onfbusiness: <br /> Name of organLwUonlbus,ness: JC's Holey Donuts <br /> Address: 616 Elleen Street Brentwood CA 94513 <br /> phone: ( 925 ) 999- 5835 Alternate; <br /> 3 List food to be sold or given to the public: Mini Donuts. Milk, Water <br /> 4. 1 am providing food that is NOT prepared at home:JZ Yes❑ No <br /> All food is pmparad on-site or is from approved commercial faciljties: ❑ Yes❑ No <br /> Name of fadllly. MJ's Dowtown Cafo Fie; (825 y 266 - 0107 <br /> Address of faclldy.655 First Street Brentwood, CA 94513 <br /> 5. 1 am providing a booth with the following: (to prated my unpackaged food and food-preparation areas from flies. <br /> dust and the public) <br /> ® A booth with walls and Coiling constructed of either wood, canvas, plas'Jc, similar material Find fine mash fly <br /> screening, oornpietely enclosing open food areas. It will also have a smooth and cleanable Itoor {concrete, <br /> osphatL dean 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 roqulrod to provide enclosed booths are those which sell beverages from <br /> approved dispensers,or pmpackagod foods from approved sources. <br /> 6. Approved water for drinking,utensil and hand washing will be provided in my booth by the following methods <br /> ®Approved bottled water. <br /> ❑ O"lln hose bib that is connected to a potable water source. <br /> ❑ Other(specify), -- - <br /> 7. Electric"is provided for my booth's use: ❑ Yes❑ No <br /> 8. 1 am providing an accurate probe thermometer to measure tho hot and cold holding of potentlally hazardous <br /> foods dunng all times of booth operation- X Yes ❑ No <br /> 9. 1 am providing the following hot temperaturo control for the hot holding of all potentially hazardous foods above <br /> 135'R <br /> ❑Camp stove N/A ❑ 5temo&hotel trays <br /> ❑ Double steamer ❑ Steam table d lids <br /> ❑ Electric stove top El Other(specify) <br /> Note'. Examples of potentially hazardous food Include: moats, tamales, cooked beans, rice, <br /> vegetables,potato salad, eggs, and dairy products. <br /> ",^Is-LV Pop 7 d 11 TUIP EANT APP <br /> Cba1:t4 '3 <br />