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4. 2016 1 2:52PM No. 2854GHIRARDELLI <br />ID. <br />12. <br />my <br />13. <br />14. <br />Health Permit <br />Paper H0ix1Td'at?I3 . <br />S«ap <br />PTcpnfW Stbr, <br />■tPropane Tank <br />Blaech and Wq^Bt* <br />Rr ft Exthgii'shAt* <br />P4ge B of ll TEMP EVENT APP <br />4. 20 1 6 1 2:50 PM No. 0539 <br />Si <br />END TG-C2 <br />11WH <br />KJ lea chests <br />□ Refrigerated truck <br />□ Other (specify) <br />St»mo wAzfeWng <br />Dljtl <br />Garbage <br />Can <br />Q Refrigerator <br />Q ice bato and tubs <br />5Gal Handwash <br />WarelwvGTlgr CorJilirw <br />Booth must be on <br />Concrete, As ph aft, <br />Plywood, or a Tarp. <br />Soniewbudw- <br />start lumping ctalho <br />5 20 Gsi <br />Hand wwxh Waler <br />/ftE <br />Ice Cooter j : <br />/l U <br />Date <br />Exira ba Sijfs & Pootf Canlalners mail be S <br />shws-d E fr>cOs? pff of ibo ffiaiftKlt <br />Received Time Mar. <br />1 lh® fofiowin9 temperature control for ths cold holding of potentially hazardous foods below <br />45 F (if food is used the following day, maintain balow 41 ‘F temperature): <br />All food vendor booths < .... <br />event A copy of this checklist must be In (helgooth <br />this avpnt <br />Completed <br />I DfooGh <br />□ Water supply dispenser with warm water at a minimum of 100T (i.e. 5-20 gallon container with spigot). <br />□ One separate tub (bucket or basin) for the collection of rinse/wastewater, <br />□ Paper towels and pump-style soap container, <br />•‘Tmportanf' All food vendor booths are subject to Inspection. Please make a copy of this applicafioTin <br />preparation for Ihis event A copy of this checklist must be In (he booth at all hours of <br />preparation and operation. Return original to festival coordinator three weeks prior to <br />p/Mwr/ <br />I $P»p andWfiler Rir^ Water <br />I CulhfiQ &o®rd <br />11. lam providing ths following items within my booth for the sanitary cleaning of food preparation utensils: <br />Q Three compartment sink. <br />OR <br />Shrfin^r dee£r?b5 (bastes 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br />solution (one tablespoon ofbleach per gallon of water), <br />□ Detergent, bleach, and wiping cloths (cleaning towels). <br />O Test strips to measure sanitation levels for bleach solution measuring 1 ooppm. <br />□ Tub to store wiping cloths in bleach solution measuring 10Oppm. <br />b^hP™'6'"9 fo!l0Vvin9 for actectuate hand washing feullltiss, but separate from utensil wash within <br />Feb29Mar. <br />EXU^ <br />VUat®f