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10. <br />I am providing the Wkxwing «ems within my booth for warewashr-g:11. <br />□ TTirco compartment $ink. <br />OR <br />13. lam providing th© foltowng for adoq/ualo hand washing facilities. but separate from utensil wash within my booth: <br />14. <br />“Important** <br />15. <br />1 <br />]CUMq tfcwi A Blench»UMM aow <br />0 <br />)n««E* <br />TEMP EVENT AP3Pf»9* 8 tit 11 <br />____________ <br />Health Permit <br />I 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 />drjvrtt A'Cfiart-'*) <br />O* <br />BflM <br />S a*l MrM MW< <br />A M«wMk*r Qxmfr <br />0rc<h rrwsi be on <br />Ccrcrota, AspbaJt, <br />PlywxxJ. or a Tarp <br />EH) lfl-02 <br />nuns <br />"I&Jce chests <br />□ Refrigerated truck <br />□ Other (specify) <br />□ Refrigerator <br />□ loe bath and tubs <br />5 JH '.1«l <br />•tail vuhW (tar <br />Garbin <br />Can <br />&•*««*> lu«* <br />bk««di B nbW fcr <br />nrmQMprqosha <br />i Ice Cooler <br />‘WWater supply dispenser with warm water at a momum of 100°F (l.e. 5-20 gallon container with spigot). A <br />Separate tub (bucket or basin) for the collection of nnse/wastewater. Paper towels and a pump-style soap <br />container. <br />(Uj» < c«n»ir*n <br />rtf'fS ini »•» art ufttm an «jmr <br />Throe deep tubs (basins 6-0 inches minimum), one for soapy water, one for rinsing and one far a Weach <br />sofution (one tablespoon of bleach per gallon of water). <br />12. lam providing the followrg Items wthin my booth for the sanitary cleaning of food preparation utensils: <br />^p^petarqent. bleach, wiping clothe (cleaning towels), and a tub to store wiping cloths in bleach solution. <br />cAM/Lp <br />Date <br />IQnM V/M«l <br />z <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 bo m the booth at al hours of <br />preparation and operation. Return original to festival coordinator three weeks prior to <br />this event. <br /> Completed by: <br />Signature <br />Names of responsible persons to be present in booth during all hours of operation: <br />/Uczrci)