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SAN JOAOUIN <br />10 <br />11 <br />OR <br />12 <br />□ One separate tub (bucket or basin) for the collecton of nnse/wastewater <br />13 <br /> <br />rat o <br />Completed by,14. <br />jg iture <br />Health Permit <br />i E- J <br />EZ3- <br />Lr <br />Ice Cooler <br />- 1 • •F J <br />’CVF CVCST AFF <br />ioO <br />I____1 <br />r <br />i4 <br />r <br />i <br />I <br />Cartage <br />Car <br />i *- <br />Bocth must t« cr <br />Csncre’e Aspnal-. <br />Plyrexrtl or a Tagi <br />EJ <br />\ <br />i <br />I <br />=1 <br />T • .4 <br />F- >.<f 1 ' <br />j <br />I <br />I <br />I <br />I <br />I <br />4-1Lir <br />- U -4 ; r- <br />CUD 16-32 <br />•;n ■' ■’! ‘:rn' <br />n Paper towels and EurnRt5tll<‘-Soap container <br />Names of responsible persons to be present in booth during all hours of operation <br />_ <br />"Important** All/! <br />pre| <br />Zrej^arZt.Oj <br />.Atfrfs dverK <br />■ i please make a copy of ths app ication in <br />A copy of this checklist must be in the booth at a.I hours of <br />Return original to festival coordinator three weeks prior to <br />od vendor booths are subject to inspection <br />for this event. A copy c. - <br />and operaworu/ I-------- - ■■■ <br />I am providtpq the following for adequate <br />booth //A <br />□ Water supply dispenser with warm water at a minimum of 100 F (i e 5-20 gallon container with spigot) <br />I am providing the follow.ng cold temperature control for the cold holding of potentially hazardous foods below <br />45 F (if food is used the following day maintain below 41 F temperature) <br />Fl Ice chests I—I Refrigerator <br />| | Refrigerated truck . , i Ice bath and tubs <br />^3 Other (specify) f <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utens.l <br />| | Three compartment sink <br />□ Three deep tubs (basins 6-8 inches minimuml. one for soapy water one for nnsmg and one for a b each <br />solution (one tablespoon of bleach per gallon of water) <br />□ Detergent bleach and wiping cloths (cleaning towels) <br />Q Tub to store wiping cloths in bleach solution ^/A <br />hand washing facilities but separate from utensil wash within my