Laserfiche WebLink
9 <br />8 <br />9. <br />OR <br />10. <br />13 <br />14.Completed by: <br />Signature Oate <br />f'KXT rtarwl <br />I ic-ic 1.'/- I ______ <br />Cuenj Baad <br />] <br />Page 8 of 11 T£VP 'VENT *PP <br />6MD 18-02 <br />1 (VI 3/D® <br />St<"a k» ». Cooa ovip-tr-r wtf ie <br />itund 9 rrrj-t rH of ff-0 ffrx-ncF <br />Garbage <br />Can <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensils' <br /> Three compartment sink. <br />2>lce chests <br /> Refrigerated truck <br /> Other (specify) <br />S-JC Oal <br />•t* . wash Aanr <br /> Booth must be on <br />Concrete, Asphalt, °lywc(XS. or a Tarp <br />Title <br />5Ga wane wash <br /> Refrigerator <br /> Ice bath and tubs <br />S«i u-w Duma:- <br />HMdi A wa -.-iV <br />UDrtrxj wiping d Wa <br />?:°vidins ttle fo'lowin9 “W temperature control for the cold holding of potenbaily hazardous foods below <br />45 F (if fooa is used the following day maintain below 41 *F temperature): <br />felutron^one^ab'le35 ('basi"®!6’8^ncfles ore for soapy water, one for rinsing and one for a bleach <br />Mpetergent. bleach, and wiping cloths (cleaning towels). <br />Ja Tub to store wiping cloths in bleach solution. <br />■IM <br />Ice Cooler -a ■■■w- <br />slit <br />^providing the following tor adequate hand washing facilities, but separate from utensil wash within my <br />..t\i Water 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 />Shaper towels and pump-style soap container <br />Names of responsible persons to be present in booth during all hours of operation: <br />fKcx\ftAA. SaacJKi <br />"Important** <br />Health Permit <br />---------------3a__________ _ _______________________ <br />All food vendor booths are sobiect to inspeebon Please make a copy of this appiicabon in <br />preparabon for this event A copy of this checklist must be in the booth at all hours of <br />preparation and operabon Return original to festival coordinator three weeks prior to <br />this event. <br />8»ne wO,i»6nr <br />f>w, <br />Rinse mm-jx I Is <br />____Lr <br />Soap ana M«iw