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to. <br />OR <br />12. <br />13. <br />“Impwt.nr <br />,s<w dispenser <br />Soap and Water Raise Water Bteeeh and Water <br />Fire Extinguisher <br />tee Cooter <br />Page 8 of 11 TEMP EVENT WP <br />StHurlJ <br />PtoweTar* <br />EHD 16-02 <br />08/01/16 <br />Extra <br />Water <br /> Stemo wlCtaffing <br />Ooh <br />U ..;i • <br />pWaaMMaMBaMBaaaaaHi <br />Extn too Baos I. Food Con^iners must b« <br />stofad t mchea oH gnundi <br />BQalHBndtwHh <br />Wastewater CoiMBinw <br />mo. a* <br />Harxlwaeh Water <br />Cvtlina Board <br />Proper* Sim n <br />3/27/2025 <br />Date <br />■■ •‘■z . ■•sS <br />Paper HandTowste <br />' /.J* .•/ • . . <br />Sanitizer bucket- ’ <br />bteach 1 water for <br />•terino wiping <**» <br />--------•■- ■ . ■ ..'.'-artii'' < '' ,2 ' <br />Booth must be W <br />Concrete, Asphalt, <br />Ptywood, oratirp. <br />Wa <br />• . ••. ’ • " r'"- <br />' rlt} temperature control for the cold holding of potentially hazardous foods below <br />^5 F (if food is used the foltowing day, maintain below 4IT temperature): <br /> loechests □Refrigerator <br />O Refrigerated truck Q foe bath and tubs <br /> Other (specify)_ __ _______ <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br /> Three compartment sink. <br />.; 11 <br />[□Three deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a htearh <br />soluton (one teblespoon of bleach per gallon of water). <br />[^Detergent, bleech, and wiping cloths (cleaning towels). .. ■/I- <br />O Tub fo store wiping cloths in bleach solution. <br />I^providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />EfWater supply dispenser with warm water at a minimum of 100T (i.e. 5-20 gallon container with spigot). <br />Gfone separate tub (bucket or basin) for the collection of rinse/wastewater. <br />□tPaper towels and pump-style soap container: <br />. ;:S <br />__________________ <br />All food vendor booths are subject to inspection. Please make a copy of this applicatton in <br />preparation for this event A copy of this checkbst must be in the booth at all hours erf <br />preparation and operation. Rfiftiip orfejnal to festival coordinator weeks prior to <br />this event. <br />Te-sus Solis <br />r signature <br />Garbage <br />Can <br />14. Completed by: