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SAN JUAIJUIN ! iiviioninentil I loalth D(,'p;n linoni <br />io <br />11 <br />OR <br />12 <br />[ | Water supply dispenser with warm water al a minimum of 100 I (i e. 5-20 gallon container with spigot). <br />I One separate tub (bucket or basin) for the collection of nnse/wastcwalei <br />[ ) Paper towels and pump-style soap container <br />13. <br />14.Completed by <br />_J>kjnaturo <br />I Health Permit <br />II ■ 0*rlSP*»pcr • <br />(tiling tlc.ir.l <br />I'rop.HT SlOyr <br />ii <br />Ice cooler <br />i ' i .'.(.4 <br />tl MPf VI N' APS <br />[ | Three deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br />solution (one tablespoon of bleach per gallon of water) <br />I I Detergent, bleach, and wiping cloths (cleaning towels) <br />I Tub to store wiping cloths in bleach solution <br />I •/(.! let' H i-Ji A I <"><1 ('oiil.invii (><• <br />Vo/Cd 61'tc' es o'l«' >'•<' <br />Stcwu <br />I>sf> <br />Booth must be on <br />(Concrete Asphalt. <br />Plywood or a laip <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />( ] Three compartment sink <br />!> ?<) C..II <br />i l.iod W.lli'f <br />(kuliage <br />Can <br />San bzer I m.Kct <br />A A.itcr le> <br />st<ww’g a iwig CioOK <br />. Al <br />throe w< <br />Date <br />i i <br />I HI) 16 0? orron?o?A <br />I am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br />45”f; (if food is used the following day, maintain below 41 "f temperature) <br />J/f Ice chests I ) Refrigerator <br />[ | Refrigerated truck I I Ice bath and tubs <br />[ | Other (specify) -— - <br />r:z <br />ll.nw W.W <br />Names of responsive persons to be present in booth during all hours of operation <br />Cep.I i f _ /ytCT-cdAuTsii <br /> <br />“Important** AliTood vendoTbooThs 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 all hours of <br />preparationi/Jud operation Return original to festival coordinator llyoo ^woeks prior to <br />this oydn//// , <br />Title <br />j II'C.K.I' <br />| : <>.i| d-spensw <br />| Soar .i'’ l A aie< <br />I a!im|diVM*r J <br />r 3 <br />I l;i/( I'.fjii Avv-'an1 | !.k)i.klo:i C.d fmi’i.iA)!> , I ?<!') <br />I 'aqe fl of 11 <br />[ Bicar b add Waii'i <br />/ I .tra \ <br />I Amer <br />*. G.!1 •land ajMi <br />I V.aMrAAtfi Co«’l.w’< ■