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1 17. 1 am providing the fo lumng cola temperalure control for the cold holding of potentlaily hazardous foods below <br /> 45'F(if food is used the following day, maintain balow 41'F temperature): <br /> ® Ice chests ❑ Refrigerator <br /> ❑ Refrigerated truck ❑ Ica bath and tubs <br /> ❑Other(specify) <br /> 11. 1 am Providing the fotivwtng items within my booth for the sarutary clearing of food preparation utensils: <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 daft(cleaning towels). <br /> ❑ Tub to store wiping colitis In bleach solution. <br /> 12, 1 am providtng the foilawing for adequate hand washing faolltlos, but separate from utensil wash within my <br /> booth: <br /> ®Water supply dispenser with warm water at a mk*num of 100'F(i.e.5-20 gallon container with spigot). <br /> ® One separato tub(bucket or basin)for the collection of rins&Wastewater <br /> ®Paper towels and m e wap container. <br /> 13. Blames of responslbla pemns to bo present in booth during an hours of operabon: <br /> Dominique Jackson d Jacob Torras <br /> —Irnportant" All food vendor booths are subject to inspection. Please make a copy of this application in <br /> Preparation for this event. A cagy of this checkitst must be In the booth at all hours of <br /> preparation and operation, efum 0119104110 11e9l9v I coordInator throe weeks orlor to <br /> thlakovent- <br /> 14. Completed by. Dominique Jackson <br /> Sl9rra Tula Date <br /> Health Permit <br /> iielTu rLTrleq <br /> o■n 1 <br /> Rolr+rr 9►r.■ _•---_ 4kwa t.err b <br /> B4a.1 F_ Z r�A.p�µrQ s^ezfN <br /> t w(h rru i t be on <br /> Cnnrueta,, Whw t, <br /> Plywood,or a Tarp <br /> P4c-cur, .• . <br /> Gari,ugo <br /> rn Van Can <br /> two <br /> wrr <br /> Ice Coale <br /> oG"h�.Vh <br /> • r.+n 1.9y. rr�.f cr(�.�-.u�tr Poet. ww Car wiw <br /> r7rw�,.:•y,cerd yr p.fl,�. <br /> U0 1 e-a2 <br /> MIUV16 Pwy a er 11 TEMP EVENT'.YP <br />