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I <br />I <br />J <br />Completed by. 14. <br />Title <br />Payer-tsra’r*?ICuwa Soi'd <br />I'CSS'l <br />? <br />Fne Exlinou'tMr <br />,4-(Mnu <br />r~’~ <br />r-r.T..rr,,-,<t.;7^r7.7~X-^'?? <br />Health Permit <br />Garbage <br />Can <br />SCaiHxxiwAt <br />A'3s-ew3>- r ConHi'er <br />5-20 Ga‘. <br />Hard watf. Water <br />ti. <br />S'erno vwCJatt.co <br />Cxtf. <br />Si\N IUMjhih <br />Soctr r-^it ” <br />Concrete As~fa* <br />Plywooa a Tare <br />I C«ira \ <br />I «atw | <br />53- ■Z'i-.-t-e <br />Sea:-- 4 »sf :■' s'OWra a ; - : <br />/ <br />Ice Cooler <br />’'Important’r All food vendor booths are subject to inspection. Please make a copy of this application >0 P^'* -r- <br />for this event. A copy of this checklist must be in the booth at all hours of preparation and operab --------- <br />original to festival coordinator three weeks prior to this event. <br />Signature <br />or f'/ ■> ■' <br />eW Zl <br />Date <br />| I IrrUl. .V'! ' • <br />one for rinsing and <br />13. Names of responsible persons to be present in booth curing all hours of operation: <br />ynnetK __ _________ <br />□ Three compartment sink0"15 W"h'n ra» ban'h tor the sanitary rtoraiq ol propwah-r' <br />OR <br />Q Throe deep tubs (basins 6-8 ineh« ■ ■ <br />solution (one tablespoon of hl^T ,n"a™'n). one lor soapy water. <br />□ Detergent, bleach, and wiPincXh?/ ?a"°n °'Waler)' <br />□ Tub to store wiping clotbs^XSuZ9 toWe'S)- <br />l^am providing the following for adequate hand washing facilities, but separate from utens.l wash 'V <br />□ Water supply dispenser with warm water al 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 pumtstylesrag container. <br />tampiw'dinilthefollowim, , <br />■lb'I til l""d is use,I the icl||0W1|1,’"’1"'',',l|l|eir>nlml l<ll |lm u.l'l hr'Hini) "I ' '' ' 1 " <br />Ice chests i i '''''' ■ni'1’,|iiiiiiho|itw'il I lefiui^iahir' ) <br />[ ] ethci specify__ t , iMtvjonibJ'l Him> <br />I i-'.-.a •»< ’<• » e!l'J Uf0‘ind <br />t <tf.PMtt Cililomu ! 1 F 2^16^)138 I -.CA.-. ;.n mpm: <br />J. 1 " • i'^H.r r. av- •rSt-.S’ ' <br />I I swpana Waiw | RtnwWJM I BteaCh ana Water