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2092396131 07:56:17 a.m. 06-05-2018 3/3 <br /> 45OF (if flood is used the WO*day, maintain below 41°F temperature): " A <br /> ❑ Ice chests ❑Refrigerator <br /> ❑ Refrigerated truck ❑ Ice bath and tubs <br /> ❑ Other(specify) <br /> 11 I am providing the Hollowing items within my booth for the sanitary cleaning of food preparation utensils: N A <br /> ❑Three compartment sink. <br /> OR <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 /> ❑Tub to store wiping cloths in bleach solution. <br /> 12. 1 am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br /> booth: <br /> ❑Water supply dispenser with warm water at a minimum of 100°F(i.e. 5-20 gallon container with spigot). <br /> ❑One separate tub(bucket or basin)for the collectlton of rinse/wastewater. <br /> ❑ Paper towels and pump-stAe soap container. <br /> 13. Names of responsible persons to be present in booth during all hours of operation: <br /> CAVM1%C- EuvSss <br /> "Imporharie" 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. R#tum ortainal to festival coordlnatr>Ir three weeks w W to <br /> eventthis <br /> 14. Completed by- l O <br /> Ignature Me Date <br /> sap oar. <br /> Heafth Permit S&VW%#cWrQ <br /> Drh PeW H"Taw" <br /> Soap afp«r.r <br /> C+rtlrq sxwjznr Wci N- <br /> I>W h a.+w'; <br /> Ptspne 8�otr. <br /> eN+rh WM www doff <br /> Booth must be on <br /> COW",Asphalt, <br /> Plywood,or a Tarp. <br /> Prnwrr Ter* <br /> Sap rtd tw', <br /> Rhr�WMrr 81wch*rW V"r Garbage <br /> Can <br /> !. Fire ErQnpu"tt�r <br /> ,_'.'. <br /> Ice CTIA7L <br /> s I+ w.M <br /> Bet 6 Food Cm*Ak e 3 mt&Dt Wa ipwMM Corttekw1rx11s�aBd/Ae prpnrl! <br />