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10. 1 tun providing the following mid temperature control for the cold holding of potantlally hazardous foods bellow <br /> 45T(if food is used the following day,maintain bellow 41`F temperature): <br /> ® Ica chests ❑ RefrigeralDr <br /> ❑ Rafterated trick ❑ ice bath and tubs <br /> ❑ Other(specify) <br /> 11 1 am providing the following items within my booth for the sanitary cleaning of food preparation utensils <br /> ❑Three compartment sink- <br /> OR <br /> JZ Throe deep tubs (basins " inches mlrumum), ono rot soapy water, one for rinsing and ore for a bleach <br /> solution (one tablespoon of bleach par 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 vmshing facilities, but separate frmh utensil wash within my <br /> booth: <br /> (�Wa!0r supply dispenser with warm water at a mrn€mum of 100'F(i.e. 5-20 gallon container with spigol). <br /> Ono separate tub(bucket or basin)for the collection of rinsaMastowatar. <br /> g Paper towels and pump-style s02 container. <br /> 13. Names of respons,bto persons to be present in booth during all hours of operation: <br /> Sue oulllcl ssa Quilld <br /> "Important" A]I fooe 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 o_rkgina_t t4 fpst"' l coordinator three weeks prior to <br /> this event. <br /> 14 Compietod by RaIA 5/14/25 <br /> Signature Titla Data <br /> a,n rr <br /> Health Permit 1Mn7 err rrr�. <br /> ?errs,rKh wfrr, � <br /> d.n <br /> Pd;.w Hrd Tr,.l■ <br /> '.�d■anrrr <br /> {u711a sure S■rnnr t.airt <br /> to bath L ii1H 1.r <br /> Rnirnt 54r1 g��r sLs1fV rt���elr. <br /> Booth m List G n cn <br /> d As Carin, phalt. <br /> x - Plyw.rod.or a Tn,P <br /> .Z Jt 7�✓ t <br /> rh„■rr rr1 _ - <br /> �q,..,aYrr� Frr•Aa�r s■vrairdWgr Gcwb*ge <br /> ' Can <br /> r�*Cr1na J star �. <br /> � rw■ �__1 <br /> Y1oer <br /> iC>a Cdoier i 3Obwhq+J.nn - <br /> rJ M71a d17A L raw UAUnrw(mm tr Wna ft"CwMv. <br /> •- -- iL•.�ad�rsTr of d Mw pt■ygr <br /> Erin 1 OZ2 FOP a or 11 T FLIP EVENT AM <br /> 05,91110 <br />