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REC-00 <br />Environmental Health Department <br />k <br />san1rawbucket- <br />t4eatilikwhieriot <br />vorios Oers cloths <br />ctittlnpboafti <br />Propane &lode <br />Mrj •:+7;_4:71= <br />17,1 <br />Booth must be OD <br />Conorete, Asphalt, <br />Piyvopti, or,e Tarp. <br />5-20 Gal. <br />Hidwaat,Wear <br />1 Pepe( Hand Towels 11 <br />loq..4.1 0.0.1 <br />DocuSign Envelope ID: A6E74685-DEDE-4900-90F6-8D6DC4F9DF9A <br />S4NI.40AQUIN <br />coti N T <br />Greotnt ,Ns .tpows hrle. <br />10. I am providing the foilowing cold temperaturo control for lho cold holding of potentially hazardous foods below <br />°F (ff food Is used the followin , rnaintatrt billow/11'T torriperalUre): <br />co chests Refrigerator <br />ofrigeratod tRick bath and tubs <br />theis(specily)_ <br />11. proViding the following items viiithIn my booth for the sanitary cleaning of food preparation utensil <br /> hreecompariment sink, <br /> hree deep tubs (basins 6-8 Inches minimum), one for soapy water, one for rinsing and one for a bleach <br />on (one tablespoon of bleach per gallon of water), <br />tergent, bleach, and wiping cloths (cleaning towels4. <br />ub to store wiping cloths In bleach solution, <br />12, I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />riNater supply dispenser with warm water at a minimum of 100°F (I.e. 5-20 gallon container with spigot). <br />erffrhe separate tub (bucket or basin) for the collection of rinse/wastewater. <br />E''aper towels and purnp-style soabcontalner. <br />Names of responsible persons to be present in booth during all hours of operation: <br />Y-,(0 <br />*Aimportan...* Ali food vendor booths are subject to .Inspeption. Please make a copy of this application In <br />preparation for this event. A copy of this checklist must be In the :booth at all hours of <br />preparation and:operation. .,Fle original to festival 000rdinator three weeks orlor to <br />event., . <br />Completed b <br />ate