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S A N.�10AQ U I N Environmental Health Department <br /> 4 <br /> —COUNTY <br /> Greotness grows here. <br /> 10. 1 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 /> Ice chests ❑ Refrigerator <br /> ❑ Refrigerated truck ❑ Ice bath and tubs <br /> ❑ Other(specify} <br /> 11. 1 am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br /> Q Three compartment sink. <br /> OR <br /> free deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br /> solu!ia�(one tablespoon of bleach per gallon of water). <br /> BDrgent, bleach, and wiping cloths (cleaning towels). <br /> ub to store wiping cloths in bleach solution. <br /> 12. 1 am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br /> booth: <br /> Mydt�er supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br /> [ One separate tub (bucket or basin)for the collection of rinse/wastewater. <br /> U,Ivaper towels and pump-stVie soap container. <br /> 13. Names of responsible ersons to be present in booth dunn all hours of operation: <br /> V yw�e,2 0 n(tom 1 1� L�D` _ _ <br /> "*Important" 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 be in the booth at all hours of <br /> preparation and operation. Return original to festival coordinator three weeks prior to <br /> this ve <br /> 14. Completed by: lS <br /> Titl Date <br /> 5-20 Gal. <br /> Health Permit Hand wash water <br /> St..wlChaffing <br /> Dish <br /> Paper Hand Towels <br /> Soap dispenser <br /> cutting Board Sanitizes bucket- <br /> bleach&water for <br /> Propane Stove <br /> Bleach storing wiping cloths <br /> Booth must be on <br /> Concrete,Asphalt, <br /> , �'r x. Off, '-d_ _! Lim Plywood,or a Tarp. <br /> Propane Tank - <br /> Soap and water Rinse water Bleach and water Garbage <br /> Can <br /> Fire Extinquisher <br /> Extra <br /> ` Ice Cooler I 5 Gal Hand wash <br /> ._...,_ I Fora ice Bags&Food Containers must be Wastewater Container <br /> stored 6 inches oNof the ground! <br /> A nnn r ,r___,a__ A..__.._ , na__,.a_._ i+_rt__:_ nrnnr r nnn Aon nAnn I r nnn A/}A nAnn i <br />