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Invit •onnicnkil I lea I th Department <br />10 <br />11 <br />OR <br />12 <br />^ti’aper towels and pump-style soap container <br />13 <br />■'Important** <br />Completed by14. <br />ISlcriKi wIC’iaH i’Q <br />I Mod ’(JAC 5 <br />I Cirfttfig IJoanl <br />*’'• i Mow <br />iI •’<; I .1 <br />Ice Cooler <br />SAN JOAOUIN <br />• I <br />n r <br />W.i!er <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />iq Three compartment sink <br />I am providing the following cold temperalure control for the cold holding of potentially hazardous foods below <br />45T (if food is used the following day, maintain below 411- temperature) <br />Mice chests [ I Refrigerator <br />I '^Refrigerated truck [ ] Ice bath and tubs <br />) Other (specify) <br />S.T'ifiZt < b.rt*ct <br />biv.ltf i *.<ti•' 'o' <br />kfoo'-g iwj ciul'is <br />Booth inusl be on <br />Concrete AsphaU <br />Plywood, or a I arp <br />•» C».v K.f'Xl <br />\\ .1 VC A . »!(• ’ <.. tn * %!•' M t <br />Gaibagc <br />Can <br />/ I ■!' a <br />I v.'.itii <br />Dijt'e <br />I lealth Permit | <br />I | Water supply dispenser with warm waler at a minimum of 100T (i e 5-20 gallon container with spigot) <br />' Zone separate tub (bucket or basin) for the collection of rinse/wastewater. <br />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 all hours of <br />preparation and operation Return original to festival coordinator throe weeks prior to <br />this event. <br />_________ <br />Signature <br />Names of responsible persons to be present in booth during all hours of operation <br />-J-L. > ----- <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 />s'] Tub to store wiping cloths in bleach solution <br />I 5 20 < >al <br />ti.i'Ml a.iUi Wall1' <br />J fiiot* »i <br />I >I',I /<«■ Z'.njv A I OOil Co'rf.ii'iC'i Ill- <br />siitrcd 6 "t’ bes cW o' /''<■ gr'Jd1'*!' <br />So.«> and Wa'<:» | ' <br />!"!>.■ I • !.>/• 'lot' AvcniH’ i J'locT.lm: 'J.ilitomi.i (r <br />•III) ’6 02 <br />CG.’W9 <br />Of., I ■'O'.i 4Ih! .‘■4/t) | I .-'u':' •!<» 1 0 I ’•;< v.wv. ('igeh I <br />Page 0 of’I HMPfVlN’APP <br />| j ll c.iei .."d'A'ntc- <br />I am providing the following for adequate hand washing facilities, but separate from utensil wasli within my <br />booth /zv /