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U-2/U3HAULMAIL BIZ LIL.12/22/2bl4 ub: 31 31 bbl ♦ I'd <br />10. <br />rny booth for the sanitary cleaning of food preparation utensils:ilowing items wilI am providing the11. <br />□ Three compartmenbcink. <br />OR <br />iths (cleaning towels).□ Detergent, bleai ind wiping <br />lution. <br />12. <br />separate tub (bucket or basin) for the collection of rinse/wastewater. <br />13. <br />••Important” <br />Completed by:14.Signature <br />Health Permit <br />PjtXUHendloiroO <br />Soep diipanW <br />Cuttr® <br />Praoano Stow <br />Prepare Tar* <br />R.nooWBtor <br />Fira Grenowterw <br />I I <br />Swttwr feefa* <br />tteadr &wl***x <br />■taring cto*>& <br />Stomo wfcr>a*ng <br />Dtoh <br />5 CW F*ond <br />VUnneWtf Ccrtarwr <br />Booth mutt be on <br />Concrete. Asphett, <br />Plywood, or a Tarp. <br />□ Three deep tubs (basil <br />solution (one tablespoon a <br />B inches minimum), one for soapy water, one for rinsing and one for a bleach <br />ich per gallon of water). <br />{_\Refriflerator <br />□ ike bath and tubs <br />MO Gd <br />Hjndwsrfi Wi*w <br />Garbage <br />Can <br />, »ra«jre control for the cold holding of potentially hazardous foods below <br />daynnalntain below 41 °F temperature): <br />vu <br />Title <br />I am providing the followingNwld tempei <br />45’F (if food is used the following c^. <br />Qleach <br />□ Ice chests <br />□ Refrigerated truck <br />□ Other (specify)— <br />w a- <br />f^lce Cooler H rii ------- <br />I____________-jcntoerncrtiicrrof^srowd.' <br />Sa^ftndWater R«reWW« | and W<*w | <br />Q Tub to store wiping cloths in bleach <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />rg. Water supply dispenser with warm water at a minimum of 100‘F (l.e 5-20 gallon container with spigot). <br />tS Paper towels and pump-style SQ8P container. <br />Names of responsible persons to be present in.booth during all hours of operation: <br /> - - <br />J>ths are subject to inspection. Please make a copy of this application in <br />J event. A copy of this checklist must be in the booth at all hours of <br />operation. Return original to festival coordinator three weelg? prior,.fe <br />Alkfood vendor <br />prepbr^tion for <br />preparafton and <br />this evenlL\ / <br />Extra <br />Wator