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1C - <br />OR <br />'3 operation: <br />Important*’ <br />' t. <br />Title Date <br />Health Pern;t I <br />- sce-'ier <br />" - - <br />I i3.;-_ ■;s? tc-r <br />Ice Coo’er <br />rIL <br />i <br />a- <br />Refrgerator <br />_ ioe oath arc tubs <br />i-oct- rnust be <br />itc'S'Ste. Asp-a? <br />p|yv.oyj or a Tarp <br /> Sa? :IZS' L.z-:s <br /> <br />I am provc’r.g the following items .vitn.n my boo‘> -p'- tie san -a.-y meaning of food preparation uiensrs <br />Three compartment sink <br />mice crests <br />.j Refrigerated t'uck <br />.. Other (spec fy) <br />J <br />i."'Pacer towels and ptn-p-stv'e spec conto -ei <br />during ar hours <br /> <br />ry--------------- <br />t -3. ? l-ar«J*^.v. ; <br />1 ’’jM' '3 ;re hxlowng coid temps rat., re c .:"'*.rc' 'z: the coid holding cf potenda'ly hazardous foods dele.'.' <br />-:;‘F f food is used nno fciiowing day. ta ntairi below d ' y- temperature>: <br />■_ '.Vater supply dispenser win warm watt-r at a mi-mum o:' 33T h.c. 5-20 gallon container with spigot; <br />-U'LzJU1— <br />C/irb- rw <br />Csr' <br />I am c-oviding t-e -ollo^inu w- adaguate hand wasS -g fac n-s b„ : seoamrte n-m ute-s ■ wash within mv <br />booth’ <br /> Three deep tubs (basins 6-5 nches minimum) we £o- soapy water, one fo rinsing and one ■'(■■■ a .■ each <br />snij-nn (one tablespoon of b'each per gallon water.; <br />•'^Detergent, b'esc- <br />f <br />I <br />___________I <br />z3 f zZT i ! <br />fw -c separate tuo bucket or bas n> fa- -re co ieotion o' ns? 'waste .’.ater. <br />CJ <br />and w’p’ng cloths .cleani-c tows s <br />JZ • eSt steps to measure sa.nitaton evels for bleaon solution measutirg tOCcpm <br />5<_b to store 'wiping sloths in bleach scijtinn measuri-g 'hCopm <br />A.I food ve do. boot, s are subject to inspection. Please make a cooy cf th s aoo'wation n <br />“ ~."-ra.io -j. this scent. A copy or this o-eo-: st must be in the booth at a! ours of <br />.. spara..on and operate- Return original to festival coordinator throe weeks prior to <br />■his event. <br />Completed by: ^^nUA-titX <br />Signature