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5 A N !O A Q U I N Environmental Healtl► Dopartrtxon <br /> }� t err►P .f6i3O*rtq COM tpnperatura cM11-01 tnr trio"Nu holding of polvottally hq 'al%j tus l0kVJ% <br /> 45'F kg k d 4 Lean It*following ddy "irita,n bekow 4VF temperature) <br /> �PC*C EJ F.efngaratot <br /> R**tgWzk'Jtruce ❑lee bath and tubs <br /> Q Ogler(SPeCtly t <br /> t f tan,provtdtrtg the toilowrng stems within my booth for the sanitary cleaning of food prgproratiOn t <br /> �T me comet rtrin ent sink <br /> OR <br /> Q Three steep tubs (t>assng" KiChes minimum), one for soapy water, one for rinsing Lind ono tot to btuacri <br /> solution(one tablespoon of bleach per gallon of Water) <br /> C1 Deiefgwit bleach,and wiping cloths(cleaning towel.) <br /> Tub to sloe wiping cloths in bleach solution. <br /> 17 1 am My,ding the following for adeQuate hand washing facilities, but separate from utensil wash within m <br /> booth <br /> JM Water supply dispenser with warm water at a minimum of 100°F(i.e.5-20 gallon container with spigot). <br /> One separate tub(bucket or basin)for the collection of rinselwastewater <br /> 0 Paper towefs and pump-style soap container. <br /> �? Na-es of responsible persons to be present in booth during all hours of operation <br /> important" All Food vendor booths are subject to inspection. Please make a copy of this application in. <br /> preparation for this event A copy of this checklist must be in the booth at aft hour`s of <br /> preparation and operation Return oil final to festival coordinator throe wooks prior to <br /> this event. <br /> 14, Completed by -------� ��- Cjz <br /> Signai4ure Title Date <br /> y:o rm <br /> ttond wean Walgr <br /> Health Permit <br /> slarnu tHCharc+etj <br /> QISh Pie <br /> CyG:�"BtsN _l <br /> RVWw�s Sa.� U�aarr <br /> SdONi <br /> Corlrfa <br /> �;y� .'.^p a.•@ a4..:a U'..r.S•+o'.. HfaKh runt Worn. <br /> C sp <br /> �-5 P <br /> Y�•lty <br /> r� <br /> .. �,..w. Y -T'-=A•,f ,�,�4 i1PIH{IM1r��.g '•,p4i�+-�„i <br /> ':.': ivarr a �. mr�,s d1 'sa,.. i �.q"S�x l.x,.u-n `: 456't+# 4 � .......�..-..•.�-. <br /> P snvlz� k 1'd+ ')t lCfs �tnr''t}`•:ltct4' �iYt:'',,3 ` +t1+• t.:,4 t <br /> - wy <br />