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RFCEIVEt <br /> MAY 2 2 2023 <br /> ENVIRONMENTAL HESA <br /> ; <br /> PERMITISERVICF " <br /> N ,QU Environmental Health Department <br /> C O U N T Y._-.-.._-. <br /> r.-i n€> o, <br /> 10. 1 am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br /> 45°F(if food is used the following day, maintain below 41°F temperature): <br /> ,Ice chests ❑ Refrigerator <br /> ❑ Refrigerated truck ❑ Ice bath and tubs <br /> ❑ Other(specify) <br /> 11. 1 am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br /> ❑ Three compartment sink. <br /> OR <br /> tThree deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one foi- a bleach <br /> ution (one tablespoon of bleach per gallon of water). <br /> KDetergent, 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 collection of rinse/wastewater. <br /> Paper towels and pump-style soap container. <br /> 13. N es of res onsibl�ee perso to be present in boot during all hours of operation: <br /> F, p <br /> 4- <br /> *"Important" 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 o ratio Return original to festival coordinator three weeks prior to <br /> this ev nt. <br /> 14. Completed by: <br /> Sig ature Title Date <br /> 5-20 Gal. <br /> Hand wash Water <br /> Health Permit <br /> Sterno w/Chaffing <br /> Dish Paper Hand Towels <br /> soap <br /> Cutting Board leach er bucket- <br /> bleach&water for <br /> storing wiping cloths <br /> Propane Stove Bleach <br /> Booth must be on <br /> Concrete,Asphalt, <br /> Plywood,or a Tarp. <br /> Profane Tank - ---�----•--"-^ --� ,.,...._ <br /> Soap and Water Rinse Water Bleach and Water Garbage <br /> Can <br /> Fire Extinguisher <br /> � Water <br /> Ice Cooler 5 Gal Hand wash <br /> Wastewater Container <br />