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10. <br />11. <br />OH <br />ub to store wiping cloths in bleach solution. <br />12.utensil wash within my <br />'aper towels and pump-style soap container. <br />13. <br />“Important** <br />14.Completed by: <br />Health Permit • I..'.:, ,-i‘,7 ih I <br />J I . . . ■. I >.; • I <br />Bleiw nSlaw <br />0ILJ <br />PnX).ine lank <br />Bic.K ’i ri.-i V. if-i <br />File ExIIikjuI".'*’! <br />Ice Cooler <br />Pago 8 of 11 Tt-MP FVFNT APP <br />f>Tiitizef I)..: >.■•! <br />I >!<•.« i. /. '..'.il. i l<» <br />.'aiitci v.ipiiifj (lolli. <br />Fxttii h i> Bitfjs & roodnxir:!»’ <br />stored 6 irviies at! ti: I'w i/iuundi <br />Slemo w.( Juittinfi <br />Disi <br />Gaibaqo <br />Can <br />Bootl- must be on <br />Concrete. Asphalt, <br />Plywood, oi a Tarp <br />IS'fce chests <br />□ Refrigerated truck <br />□ Other (specify) <br />□ Refrigerator <br />bath and tubs <br />■h li.ll ll.rx; <br />FHD Ki 02 <br />Oa'OI/16 <br />Wish I <br />// <br />Signati Title Date <br />1 <br />Sew .Iliff W.lh< <br />&tfVator supply dispenser with warm water at a minimum of 100 F (i.c. 5 20 gallon container with spigot). <br />&dnc separate tub (bucket or basin) for the collection of rinso/wastowator. <br />N^os^resp^n^ble^persons to be present in booth during all hours of operation: <br />Rrt.i'W.iM <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 three weeks prior to <br />this event. <br />I am providing the following for adequate hand washing facilities, but separate from <br />booth: <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br />P'Three compartment sink. <br />d0?3m,I)S ^basi'1s 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 />[2<5otorgent, bleach, and wiping cloths (cleaning towels). <br />< .iiiitKi Boiirti