Laserfiche WebLink
10. <br />11.I am ppaviding the following items within my booth for warewashing: <br />Thn compartment sink. <br />OR <br />12. lam providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br />Detergent, bleach, wiping cloths (cleaning towels), and a tub to store wiping cloths in bleach solution. <br />13. lam proyidlng the following for adequate hand washing facilities, but separate from utensil wash within my booth: <br />14. <br />“Important** <br />15.Completed by: <br />Health Permit <br />PXMtr HaM TWrtftl <br />Cirif.nq Beard <br />II <br />Fm fc'jrtinaunbcr <br />* <br />Page 8 of 11 TEMP EVENT APP <br /> r- <br />CHO 1602 <br />7/14/15 <br />I am providing the following cold temperature control for the cold holdng of potentially hazardous foods below <br />45"F (if food is used the following day, maintain below 41 ’F temperature): <br />rxtra let) fl Fowi rryjSi bo v <br />•torw/ 6 ifKAC* off n/lfM 5 <br />w.’Oin'Uxj <br />Oslt <br />□ Refrigerator <br />□ Ice bath and tubs <br />Gama go <br />Can <br />E t»cn & water for <br />tMpirXl Pt*** <br />Booth must be on <br />Concmlo, Asphalt. <br />Plywood, o/ a Tarp. <br />5 H3,*k3 wal*. <br />5 20 G< <br />Hmd ~»*h Wafer <br />Z.„,.. ■______~ <br />Ice Cooler | <br />»ton«f c Aei off c/ thn <br />Title Date <br />IT <br />ilntfl Water <br />(jfThree 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 />LM Water supply dispenser with warm water al a minimum of 100*F (l.e. 5-20 gallon container with spigot). A <br />separate tub (bucket or basin) for the collection of rinseAvastewater. Paper towels and a oump-stylo soap <br />container. <br />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 />thl< event, <br /> <br />(/ Signature <br />I hrtpann Twi> <br />?. Z ' <br />Names of responsible persons io be present In booth during all hours of operation: <br /> <br />□ Ice chests <br />Q Refrigerated truck <br />□father (specify):Jr^‘2£r