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<br />« <br /> <br />13. <br />Randy Whetstone , Adaire Whetstone <br />14. <br />Health Permit <br />PapOT Hand Tcwot* <br />Propane SK*« <br />1 - <br />“Important** <br />■. I ■ ■ ■ <br /> Refrigerator <br /> Ice bath and tubs <br />v <br />i <br />•k <br />SwmowChstfinn <br />Otoh <br />^nJtte®rtud«t- <br />: btaKh.A.**terfcr <br />ttorinQWpinQ cfotti* <br />«I <br />8 <br />1 I .aa <br />^0^ <br />. Soap dJ»pen»or I £_ _I■■ . <br />~^r <br />V-'.. <br />fl <br />Z2I I <br />FA <br />alfW <br />Title <br />SsTsS = ' <br />Cattirp Board <br />Completed by: <br />| PropwwTank £u ........... .7 V, Mg <br />Ice Coole <br />f|<8^ Mt <br />| y.--r •rrr~^T-—r: —— ......................... <br />10. lam providing the following cold temperature control for the cold holding of potentially hazardous foods below <br />45°F fif food is used the following day, maintain below 41 °F temperature): <br />E) Ice chests <br /> Refrigerated truck <br /> Other (spedfy)_ <br /> Three compartment sink. <br /> Three deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br />solution (one tablespoon of bleach pergallon of water). <br />H Detergent bleach, and wiping cloths (cleaning towels). <br /> Tub I o store wiping cloths in bleach solution. <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: i . . . ' ,i8<F8^"8'?^ <br /> Watc r supply dispenser wdh warm water at a minimum of lOO’F Cue. 5-20 gallon container with spigot). <br />i 1 , <br /> One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />£j Paper towels and pump-style soap container. <br />Names of responsible persons to be present in booth during all hours of operation: <br />uirs cvum. . / . <br />Signature <br />I I Btoct. L <br />. 1------—rX <br />?| - a <br /> <br />Au'iy! ■'< 11 | <br />■ / Extra \ <br />, , Uwrtrr ; <br />J . 5^ <br />............f <br />AU 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 operation. Return original to festival coordinator three weeks prior to <br />this event. ,------—------ , , . <br />_z___... , \lD . <br />Date5 <br />_ _______ <br />S2O GM. I <br />Hxndwa*hW»ter | <br />/ r <br />Booth must t» on <br />8,- Concrete, Asphalt, . <br />JjMT Plywood, or a Tarp. <br />' I ^Ertnoukher | <br />j|L„... <br />■ • ■ ' ;■ -S‘ <br />i -A- ■ ' <br />■■ <br />I L-J <br />“ PFVFNT APP' ’ <br />________________ <br />I am pralviding the following items within my booth forthe sanitary cleaning of food preparation utensils: <br />l8 <br />OR