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S A N ! OAQ U f N Environmental Health Department <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 /> ®Three compartment sink <br /> OR <br /> ❑ Three deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br /> solution(one tablespoon of bleach per gallon of water) <br /> ❑ Detergent, bleach, and wiping cloths(cleaning towels). <br /> ❑Tub 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 /> ®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 /> ® Paper towels and pump-style soap container <br /> 13 Names of responsible persons to be present in booth during all hours of operation: <br /> MJ Bermudez, Gefc Roagwn <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 ev rat. <br /> 14, Completed by. Owner 11/26/2024 <br /> gnature Title Date <br /> Health Permit <br /> '��' 'aprl rand TCHe1S <br /> :Peen•15pEn8P.l <br /> 0.lUnq 3nAr; SarlldiEr fi <br /> fHpe[f b waner ter 1rn <br /> Srtf"rlQ 1YI{Pn9:Ighs <br /> 6leaCn <br /> Proualle Seovn <br /> Booth must be on <br /> O Concrete,Asphalt. <br /> Plywood,or a Tarp <br /> �,Wl a Tarty <br /> Sugo and�:aler Bnse Naer 9lerv•+ ;Mier Garbage <br /> Car. <br /> Erlra <br /> \1latMl <br /> ice Cooler 5Gal MnrW+•n3 <br /> �rra+CC.frays 3`OV0+1_00ra+ners musf AP `I'laFrCw+aer VanW+�N <br /> stored S rncnw;W ar fhe.7rourd' <br /> _ :la=2f' - +_ -i.__ 'i-. .�,..:.f ll•f� :.� aj4�= Z -- 'i. ._.. _ F _ -1:.a.-,.1 „-+r ;:1•:j:]', �l j:?fl it <br /> �!1D 1fi 02 gaga a of 11 TEMP eVENT APP <br /> 07foVM4 <br />