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10. 1 am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br /> 45°F: <br /> Oce chests ❑ Refrigerator <br /> ❑Refrigerated truck ❑ Ice bath and tubs <br /> ❑Other(specify) <br /> It. I am providing the following items within my booth for the sanitary cleaning of food-preparation utensils: <br /> ❑Three compartment sink <br /> Two deep tubs(basins 68 inches minimum),one for soapy water,the other or rinse and bleach solution. <br /> 6etergent, bleach and water(one capful per gallon of water). <br /> 12. 1 am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br /> booth: <br /> Water supply dispenser(e.g.5-20 gallons, Igloo or Coleman container with spigot). <br /> A'One separate tub(bucket or basin)for the collection of rnsetwaste water. <br /> ,`Paper towels and pump-style soap container. <br /> 13. Na��Esof esponsible pe too} present in booth during all hours of operation: <br /> ti'T77�r-- <br /> 'Important: AN food vendor boofhs are subject to inspection. Please make yourself a copy of this <br /> application in preparation for this event A copy of this checklist must be in the booth at all <br /> hours of p gran and operation. Retum original to festival coordinator two months <br /> prior t is ee / <br /> 14. Completed by. � i� <br /> Signature True to <br /> ,o x ro ti man � Health Permk <br /> rr snow.o s'v, z arz cx <br /> s�ao wUaa'ay arm emn wr. <br /> Osn <br /> Paper liaW Taeer <br /> Snap Srpam <br /> CUYrg acarol <br /> &Da`� Must be m <br /> p.npv+so.. Convete.Asphalt <br /> PWwood.or a Tam <br /> Pmpar TaN .— <br /> Garbage <br /> Soap arat warn area aria War Can <br /> rmr <br /> Fare <br /> Eeba Id Bags mag be slwea ort d tM <br /> Ice Cooler <br /> ;.- Poeecadaiba m�waaeemwme waa.wwk:a+.,ar <br /> mw <br /> o+o-raora� Page 8 of 9 TEW EVErrt err <br /> avrrow <br />