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10. I am pmWin the followng cold temperature contrd for the cold holding of potentially hazardous foods below <br /> 451E (11 food is used tho fallowing day, maintain below 41'F temperature); <br /> ® Ice&gists ❑ Rafrigerator <br /> ❑Refrigerated truck ❑ Ieo bath and tubs <br /> ❑Other(specify) <br /> I tarn providing the fonawing dems within my booth for the sanitary cleaning of food pmVwation utensils. <br /> ❑Three compartment sink <br /> OR <br /> ® Throe deep tubs (basins " Inches minimum), one for soapy water, one for rinsing and one fat 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 1 DO'F(La. 5-20 gallon oontainer with spigot). <br /> One separate tub(bucket or basin)for the totlection of rinselwastowater. <br /> ® Paper towels and Ito soa ountaner. <br /> 13. Name5 of responsible persons to bo present in booth during av hours of operatiorL <br /> 6 anka Masse <br /> "IrnportaM" AA food vendor booths are subject to inspocbm, Please maka a copy of this application in <br /> preparation for this event. A copy of this cheddist must be In the booth at all hours of <br /> It tg ration a o ration. urn on inal festival cop r three we r to <br /> Hits <br /> 4/2/2025 <br /> 14. Completed by- <br /> Slgnaturo Title Dote <br /> ran...+,w.rr <br /> Health Parmlt <br /> 6r+a wp+.n.q <br /> fah ppry.11/q lard■ <br /> CYrT A�ka <br /> Bum must bo cn <br /> Camn;ta.Asphalt, <br /> ` 7 PlywoW,or a Tarp. <br /> e .v torn Ia>,.'/r.rr BysY era'Nrr Iaa�alx <br /> Can <br /> _ Fkv Edr-ac+hm � <br /> Wrr <br /> Ice Cooler J • sa4A NOV r..h <br /> E.nt Ay�+Y r f.yt.f Cnes.-��••,�t. W FP9VWWW[mr.►-w <br /> DID 10-02 PeCe 6 d 1+ TEW EVENT APP <br /> Mq 111 U <br />