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S ii N MOWN Environmental I--leaith Departrnont <br /> ' 10. 1 am providing the following 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 /> (]ice chests n Refrigerator <br /> Refrigerated truck U Ice bath and tubs <br /> i []Other(specify) <br /> 11_ 1 am providing the following items within my booth for the sanilary cleaning of food preparation utensil <br /> (-I Three compartment sink. <br /> OR <br /> L Three deep tubs (basins 0-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br /> 1 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 100"F(i.e.5-20 gallon container with spigot). <br /> ❑One separate tub(bucket or basin)for the collection of rinselwastewater. <br /> ❑Paper towels and lump-style soap container. <br /> 13. Names of responsible persons to he present in booth during all hours of operation, <br /> '"Important" All food 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 original to festival coordinator three weeks prior to <br /> this event. <br /> 14. Completed by: ! L <br /> Signature Title Date <br /> 5.70 G+d <br /> Health Permit 1a°'°afh.YPYr <br /> brsh r(�I law,r W-1 111904 <br /> CW°•p llca•J 5vr°tc[lacArb' <br /> Welch A wal.f Irr^1III <br /> r>Jbpvr s:o+e CIeaV, °' J"'!t''V SrX'N 1- � l 1 <br /> f30otli musl be on <br /> Concrete.MIAMI, <br /> r'lywonti Ora Tarp. <br /> t _-]! S°°P a•.e'Na[c[ sloe WA?v 1 rilca[n„•d V.'a r (i 7r11:7 Jr' <br /> EYR F..VS.r.i.r,hC.• <br /> �11I N�en, <br /> Ice Cooler ----- `� <br /> -- SGaI <br /> I h.tra k¢lraq$6 Ftod CarKavn�.s muef b¢ YJsyrt'anlrr CngJa nar <br /> Stated 6 Wrens CIO Cr Or 7 4imf' -...� <br /> 1868 E. f lozvfton Avernre I :iloc ktori f ab(ornta 95 05( 'T 209'166•34�?0( F ;Mtl-16d-0I'Pi ( �nanv::;ynv.crrcJrelnl <br /> I'Irrl 16-02 [logo8u i1 7YMPFVhRr AM) <br /> orif1911 s <br />