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8. 9.I am providing the following items v/ithin my booth for the sanitary cleaning of food preparation utensils: OR 10. supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot) tub (bucket or basin) for the collection of rinse/Vwastewater. 13. "Important** 14.Completed by: Signature Health Permit Prepare Sova Bfeatn Rose w'zrsr a«ar>£C Aaar Ice Cooler Page fl of*1 TEMP EVENT APP I Sc^3 ee£^3&EccdCMe®-r«.'3Eisrfce &C '>£2 Detergent, bleach, and wiping cloths (cleaning towels). to store wiping cloths in bleach solution. □ Refrigerator □ Ice bath and tubs 03ce chests □ Refrigerated truck □ Other (specify) Stono CXf*! 5Ge< Hsrwwazi tf.as&jrtcsr Car.LaAsj 5-20 Gsf. Hand«ffiSi7^er Booth must be on Concrete, Asphalt, Plywood, or a Terp Garbage CanQ SoTtaerbix^tt- stotingwprg dore Qt^er^ y-zr/7 Title Date Names of respon^bleperaj^ ti^^prejseg^ir^goth dunng al hours of operation: □ Three compartment sink. E^three deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach solubOT (one tablespoon of bleach per gallon of water). SAlplise^ser I I am providing the following cold temperature control for the cold holding of potentially hazardous foods below 45°F (if food is used the following day, maintain below 41 °F temperature): I am providing the following for adequate hand washing facilities, but separate from utensil wash within my booth: All food vendor booths are sub,ect to inspection. Please make a copy of this application in preparation for this event. A copy of this checklist must be in the booth at all hours of preparation and operation Return original to festival coordinator three weeks prior to this evemt /] LCuargBoart I ------ 'Ons