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SAN JOAOUIN J iiwii-ottMir.'iHul I lonlih linen I <br />io <br />11. <br />OH <br />12 <br />I | Water supply dispenser with warm water at a minimum of 100"l- (i c. 5-20 gallon container with spigot) <br />| One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />i | Paper towels and pump-style soap container <br />13 <br />“Important' <br />Completed by:14. <br />I I lealth I’ermil <br />P.»FV< Hjn I I ov.civI-Soap dispenser <br />Ci’lii'M IkKird <br />Ittr.v br»;'i'.uK' Stove <br />Jo LX. <br />Illviirti :i vlW.H. iaiwi 'A .ib-<H»isr W.HM <br />II •'<* I <br />Ice Cooler <br />2/13/25 <br />DateSignature <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />I ) Three compartment sink. <br />b (fill IC| «1 fr.rjl <br />A.f-ii A.ViT Cdiibnnv' <br />S-iiHizcr tiu'.Kel <br />(■Irjth 4 ante' toi <br />lloolh intisl be oi' <br />Conactc. Asphall. <br />Plywood, or a larp <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 />| | Detergent, bleach, and wiping cloths (cleaning towels) <br />[ j Tut) to store wiping cloths in bleach solution <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />I »f/j icc (Mgs A I ood Cor /avico (t- <br />sM/rJ 6 wKbes <»Hct tbc <br />Garbage <br />Can <br />t <br />I HI) 16 0? <br />O/r0V20?4 <br />W'.vv. • ; J: <br />11 Ml-1 vi tr API- <br />Names of responsible persons to be present in booth during all hours of operation <br />Tori Swimlcy, Anna Swimtcy, Sam Swimlcy, Jack Swimlcy <br />11 <br />I rfr >> \ <br />I <br />All food vendor booths arc 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 al all hours of <br />preparation and operation Return original to festival coordinator throe weeks prior to <br />tliis event. <br />Ji <br />Title <br />!. ^0 (in- <br />ri.vid z.iKirAnivr <br />I am providing (he following cold temperature control for the cold holding of potentially hazardous foods below <br />45 "1- (if food is used the following day. maintain below'ITT' temperature): <br />I ] Icc chests 1 ) Refrigerator <br />| ) Refrigerated truck I I Ice bath and tubs <br />I | Other (specify). ..... ....... . <br />I la/uil.on Avi’iiui-1 : .loci'.tmt C.ii tcimi.i . I J'n't ?..t m • I <br />I’.wx; 3 ol 11 <br />lit <br />Slcn-u <br /><>.vi