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SAN JOAQUIN ! nvii oiiHiC'iH.il l lc'dKh l.)c|)< j imenl <br />io. <br />N/A (Pre-bottled Olive Oil) <br />it. <br />OR <br />12 <br />l^/Walcr supply dispenser with warm water at a minimum of 100"l; (i e. 5-20 gallon container with spigot). <br />j^Kone separate tub (bucket or basin) for the collection of rinsc/wastcwater <br />l^’apcr towels and pump-style soap container <br />13 <br />“Important** <br />14.Completed by: <br />Slcrruj w/CtbMUHi <br />IqavK <br />Cvltino llo.wd <br />M I <br />II IIWkI- .tkI A'.H-rH»>M Wllo <br />Ice Cooler <br />Owner <br />Title <br />2/25/25 <br />bateSignature <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 cold temperature control for the cold holding of potentially hazardous foods below <br />45'T; (if food is used the following day, maintain below 41T temperature): <br />I | Ice chests I I Refrigerator <br />[ | Refrigerated truck ( | Ice bath and tubs <br />\^(Other (specify) <br />I am providing die following items within my booth for the sanitary cleaning of food preparation utensil <br />I ] Three compartment sink. <br />b Ctol iLvm wjmi <br />GarlKign <br />Can <br />Still.WC/ tiuckct <br />Urti'Ji A wah'i lv' <br />Uiirun) A,pn,) d >f \ <br />Booth iimst 1)0 or <br />Concfrio Asphall. <br />Plywood, or <i I arp <br />I <t'j Ice ll.igi A I ooil Co'iM '«vs f'usl lie <br />A i'KIic < c><z <>/ piO'iiiJ' <br />b 70 UT <br />H.vvl ».i\li Water <br />>:;m. t I l.i/t lt:.u Avi iiia' | <br />I HI) 16 0? <br />07'01 ?0?A <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 three weeks prior to <br />thisxw.ont. <br />Names of responsible persons to be present in booth during all hours of operation <br />Bethany dutra t .Chris Dutra _____________________ <br />I | 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 />^Koetcrgent, bleach, and wiping cloths (cleaning towels) <br />[ I Tub to store wiping cloths in bleach solution <br />[ I He ar I. <br />| Snap <li«|ifr>M « <br />| ' IPX <br />| l*rv|u>ic Slcvr <br />I PC I »*..iKpl’SFirx | <br />14i><.l'.t<i:i C.:' foil-!.i , I ?0f) 4f-". i’.-i ’() • I 2D'i C I ;< wwv. •.]')()« iy<i c 'l.i <br />I’.-jgcOctf 11 II Ml* I VI N' 7.1 •!' <br />r r / <br />So«P .ir«l | | <br />| I lealth Permit