Laserfiche WebLink
S/WOAQUIN Environmental Health Departmem <br />12. <br />Water supply dispenser with warm water at a minimum of 100 F (i.e. 5-20 gallon container with soiqot'.. <br />13. <br />"‘Important” <br />Completed by:14. <br />Sic'nv * C*r <br />.«> <1 V. .Itf <br />O'- <br />Ice Cooler I <br />.v <br />f n' ’ <br />I -f <br />i <br />I am providing the following lor adequate hand washing facilities but separate from utensil wash within my <br />booth: <br />^2 One separate tub (bucket or basin) for the collection of rmse/waslewater. <br />.2^\Paper towels and pump-style soap container. <br />Garbage <br />Car <br />10. <br />bOo <br />I6-0? <br />t «7j fee L’jss 4 fuco ■•ii-j.’ te <br />re’ll), ./'nffie <br />I am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br />45JF (if food is used the following day. maintain below 4 TF temperature)’ <br />Ice chests Fl Refrigerator <br />L.1 Refrigerated truck Ice bath and tubs <br />FJ Other (specify) <br />B >o;n mu-r !i«. <br />'./Oncre:'} Asp1 <br />3;yvkcoc. • <br />\L <br />: \ <br />Signature <br />r '•>.»!ftivi ■. <br />Names of responsible persons to be present in booth during all hours of operation: <br />/V, /f) /> // Z//7i u J / / .4 //' d <br />FJ Three deep tubs (basins 6-8 inches minimum), one tor soapy water, one for rinsing and one lor a bieac <br />solution (one tablespoon of bleach per gallon of water). <br />1j' Detergent, bleach, and wiping cloths (cleaning towels). <br /> Tub to store wiping cloths in bleach solution. <br />| GtiBo'c Ua.r'l <br />1^ Health Hermit ] <br />Hi J I v <br />I I <br />• i I am providing the following items within my booth fo1’ the sanitary cleaning of food preparation utensil <br />■ J Three compartment sink. <br />OR <br />01/12/24 <br />‘-■r-. j.,' <br />■'.I’.J A .T •' I <br />All food vendor booths are subject to inspection. Please make a copy of this application m <br />preparation for this event. A copy of this checklist must be in the booth at all hours <br />preparation and operation. Return original to festival coordinator three weeks prior to <br />this event. /? „ <br />-s’ >1/ K,; fay *■ th S <br />1 Title