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Oct 182204:01a Phyllis (916)6869495 p.3 <br /> .)nN (� �� i rtvii•t�l�rnental !"��: Ift} C)epartmont <br /> 10, 1 ant providing the following cold temperrrture control for the cold holding of potentially harirdous foods belovr <br /> 45'f7 (if food i%used the following day, maintain below 41`T tentperatura)' <br /> _l Ice chests {_j Refrigerator <br /> L.J Rofrigerated Inick E.,] tcc batlti and lobs <br /> Other <br /> 11. I am providing lice lopOwlny itcixrs within my bt)olh for the sanitary cleaning of food preparation utensil <br /> .J Three comparlment sink. <br /> Of? <br /> three deep lubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br /> solulion(one tablespoon of bleach poi'gallon of water). <br /> Oetergent, bleach, and wiping cloths (cleaning towels). <br /> Tub to store wiping cloths in bleach solution. <br /> 12, t am providing the following for adequsle hand washing} facililles, but separate front utenskl wasf7 within my <br /> booth <br /> 4 Water supply dispenser with warm water at a minimum of 1001'(i.e. i 7..Q gallon container with spigot). <br /> One separate tut)(buckel or basin) for the collection of rinschtrasteWotcr <br /> Paper towels and hurt}p-style_soap canlairlor. <br /> t? flames of responsible persons to be present in booth during all Hours of operation"Important" F 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 11rior to <br /> this event. (. L-Cr <br /> t 4, Completed by: _ - - -2 Z <br /> Signature Title Date <br /> Y7U Gw' <br /> ---'�—" I r,.•J rmd,t':ate <br /> Heallh.Perrnil <br /> h 1'4.cr Hn.H!rcr.Ms <br /> i.hyn II <br /> `inaP er..ppveyr .- <br /> ("Ot—,EM:aM mro:arl.R wwlti•�^__iipeih Hoist lX.'411 <br /> r, 1 .: CnnCrcic,hspllaEl. <br /> -- U �« 1Mywood,or al ail). <br /> Y.W.•1 -� Galba[rr' <br /> Curl <br /> r/ k a:ra <br /> ice Cooler <br /> f - ` ; .r,r.,. •err",r......., .., rr � ....-:cwa'c ;:-rNr.r_ � ---... ....--.- <br /> L.'.r•:+i M-h4•S/Tr(f f f'N'rJri.lMl'il <br /> Av-:rluo I :-Aorkilli1 5;,11417fola !.1;;?!}; I T :'Oi).Mitt-:3.i:?{} I fr 'lt)!!.11;rt-il I t< w4vN,:;)+.3rw t)rc)!1)lrtl <br /> r rU •.1;•G' <br /> r1:ar3c no'+ti rVMrr i:vrrn Hirt• <br />