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10. <br />11. <br />OR <br />12. <br />13. <br />'‘Important*’ <br />Completed by:14. <br />Health Permit <br />I i-icm Hund rcwes <br />A'5DO'»» S'"*" <br />LL <br />rlMMii nibI£*Mp WK! ^tef <br />Ice Cooler <br />=Hn-6-C2 <br />.•■Win <br />^'Refrigerator <br />Q Ice bath and tubs <br />b Gid Mrrd <br />WWffwtti CorUAr^t <br />!wn Oil <br />I Im; rtUM <br />Booth must be on <br />Concrete, Asphan. <br />Plywood, or a Tarp <br />flHrro Mrhifva <br />CWl <br />Zti-irua buCKCT. <br />hMfrt- k MlM fir <br />ilal'ig ■Afc+’g Oot’4 <br />Paua 9 u( 11 TEMP bVbNT APP <br />Processed by FREE version of STOIK <br />Mobile Doc Scanner from www.stoik.mob <br />1\1 ft /■ C c ~f _—' <br />All food vendor boothsVra subject to frsp^ction. Ptease make a <”Py nf <br />nlnSh-m for thia event A copy Of this Checklist must bo in the booth el all hours of <br />p^aratlon and operation. Return original to ftgtival CQ^inator wojfa priorJa <br />this event <br />Fhuk- <br />ri~r? <br />Title <br />dMXfMr <br />Z2 <br />SarbaQa <br />Can <br />I RrwWW <br />a bleach <br />K* hup t /irK> liiK.1.! rtv-W iiO H <br />I Annma TA*k <br />z/Zv/zy <br />Date <br />-gThree compartment sink. <br />□ Detergent, bleach, and wipmg dolhs (cleaning towete). <br />tzfiub to store wiping cloths In bleach solution. <br />Mod S, -8« -W <br />booth- <br />dlspen- ^.h -m « - * of 100T <i.o. ^Hon coiner <br />□ One BopeW tub (bucket or basin) far the cntlectai °< nns^astewster. <br /><7 Paper towels and pumP-aYlQ_SQ§B container. <br />Names □< responsible persons to be present In booth during all hours of operation: <br />lYtftEK <br />□ Ice chests <br />Q Rafngerated truck <br />'□ Other (specilyl------ <br />lam^d..to^^--™^toto.^^ngottoodpWp.^u^: <br />' totopeSv <br />Slgnature <br />I UiUigBainl | <br />for soapy water, one for rinsing and one for