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IQ <br />I am providing the foUo^ing items within my booth foe the sanitary dcaning of food preparation utensils:11. <br />□ Three compartment sink. <br />OR <br />□ Detergent, bleach, and wiping cloths (cleaning towets). <br />□ Tub to store wiping cloths in bleach solution. <br />12. <br />soap container. <br />13. <br />•'Important** <br />cCompleted by:14. <br />Health Permit <br />CtBrvj sows <br />rUM»*Prxa-fl <»v"- <br />I rw I O'uurfw <br />Ice Cooler <br />ILMJ'LVtNT AlTP.W 8 Ot 11 <br />re?ir*i <br />EH7) te<K> <br />ceome <br />□ Three deep tubs (basins S-8 inches minimum), cne lor soapy water, one f<x rinsing and one for a bleach <br />solution (one tablespoon ol Ueach per gallon of water). <br />□ Ice chests <br />O Refrigerated truck <br />□ Other (specify) <br />□ Refrigerator <br />□ loe bath and tubs <br />Gfirtoaoe <br />Can <br />5 Qd HW <br />»w5r»» *:• <br />Rcxjrh nujsl teon <br />Cooere-e. AspnaR. <br />Pb‘A'004 oraT^p <br />I am providing the following for adequate hand washing fadfities. but separate from uterisS wash within my <br />booth: <br />0Water supply dispenser with warm water at a minimum of KXFF (i.e. 5-20 gallon container with spigot). <br />QOne separate tub (bucket or basin) for the collection of rinse/wastewater. <br />S^Papertowels and pum; <br />Title <br />J <br />SCX>WW«*fa» <br />t*eov»* >v« <br />ILZJI _z_ <br />Mrt&'MKr <br />All food vendor booths are subject to inspection. Please make a copy of this application in <br />preparation for ths event A copy of this checklist must be In the booth at all Iteurs of <br />prppafaticn and operation. Return original to festival coordinator three weeks prior to <br />this <br />Names of respocisate persons to be present in booih during all hours of operation: <br />fonhllA. . ChfiS V_______________- <br />520 W. <br />Hartl <nar> Water <br />I am providing the foBow..0 cold temperature control for the cold holding o. r ^tentially hazardous foods below <br />45uF frf food is used the foifowing day, maintain below 41T temperature): <br />for RlOi 4 «»< I