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TEMPORARY FOOD VENDOR'S APPLICATION l <br /> f <br /> All food vendors (both for profit and non-profit)are required to return a signed and completed copy of this checklist to <br /> the festive{coordinator three(3)weeks prior to this everrt. Saturdays <br /> 1. 1.Name otEvent:� Downtown Tracy Farmers Market _ ` Dete(s): Year Round 3 <br /> 2. The following is Infonmatton about my organ lzation/business: <br /> Name of orgenization/business:_! _ 1 19 f_ _ SA LICE Z-1-C <br /> AWMW LILI10 f442lu,oA/5'HICL tVl� <br /> PhMi {20� ) - ��.3 � Altemeta: ( ) <br /> 4. 1 am providing food that is NOT prepared at home: ErYes ❑No <br /> Ali food is prepared on-site or is from approved commercial fecilities: E�Yes ❑No / �y <br /> Phone: {2� ) <br /> 'i�Ei4sfa�li#j►: z fig' S'. GilJ!�� I�U�IC� S i� � . Lta b l , �►`i �S^���f'� i <br /> 5. 1 am providing a booth with the following: (to protect my unpackaged food and food-preparation areas from flies, <br /> dust and the public) <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, dean tarps and smooth wood are acceptable) and constructed to separate food and food preparation <br /> areas from the public. <br /> &Dther(specify): IbIESVIE a PPL Y <br /> I <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. f <br /> S <br /> B, Approved water for drinking,utensil and hand washing will be provided in my booth by the following methods, ` <br /> ❑Approved bottled water. <br /> ❑On-site hose bib that is connected to a potable water source. <br /> 2rOthar(specify): 1-4 A 1A TE '1�1!SP&q.s&=2 } <br /> 7. Electricity is provided for my booth's use: ❑Yos4m <br /> 8. 1 am prrnriding an ar curats probe thermometer to measure the hot and cold holding of potentially hazardous <br /> foods during all tunes of booth operation:❑YesZLNa <br /> 9. 1 am providing the kgkNdng hot temperature control for the hot holding of all potentially hazardous foods above <br /> 1350F: tDo GA'T <br /> ❑ camp stove ❑Stemo&hotel trays <br /> ❑ Double steamer ❑Steam table &lids # <br /> ❑ Electric stove top ❑Other(specify) <br /> I <br /> Note: Examples of potentially hazardous flood include: meats, tamales, cooked beans, rice, <br /> vegetables, potato salad,eggs,and dairy products. <br /> rim te-oa page r 0111 TEMP EVERT APP <br /> Mille <br /> l <br /> r <br />