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FOOD VENDOR PERMIT APPLICATION Page 2 <br />10. <br />I am providing the following items within my booth for the sanitary cleaning of food-preparation utensils:11. <br />12. <br />13. <br />Completed by:.14. <br />Signature/Title <br />No Smoking Sign <br />Stemo w/Chtffing Health Permit <br /> [ <br />Propane Tank <br />"Soap and Water <br />rins Extinguisher' <br />Page 2/2 Rev 10/14/2015 <br /> Three compartment sink. <br />deep tubs (basins 6-8 inches minimum), one for soapy water, the other for rinse and bleach solution. <br />Detergent, bleach and water (one cap full per gallon of water). <br />Names of responsible persons to be present in booth during all hours of operation: <br />Humberto Mireles-Romo__________________________________________________ <br /> Refrigerator <br /> Ice bath and tubs <br />Extra <br />Waler <br />I am providing the following for adequate hand washing facilities, but separate from utensil washing <br />within my booth: <br />Your hot & cold food temperatures will be monitored. Your hand washing and sanitation processes will <br />be checked. PLEASE meet the required standards as addressed herein. <br />2-1/2 Gal <br />Must be on <br />Concrete. Asphalt, <br />Plywood or a Tarp <br />fy Ice chests <br /> Refrigerated truck <br />Q Other (specify): <br />Garbage <br />Can <br />3 GSI Wish <br />Waste Water Container <br />D <br />Ite Cooler ( <br />I am providing the following cold temperature control for the cold holding of potentially hazardous foods <br />below 45° F: <br /> I Bleach <br />FX Water supply dispenser (e g. 5-20 gallons, Igloo or Coleman container with spigot). <br />CwOne separate tub (bucket or basin) for the collection of rinse/waste water. <br />Paper towels and pump-style soap container <br />j I Bleach and tarter <br />of the ground! <br />Food Confarnefs must he stored <br />oft the fktor1 <br />IMPORTANT <br />All food vendor booths are subject to inspection Please make yourself a copy of this application in preparation for this <br />event A copy of this checklist must be in the booth at all hours of preparation and operation. <br />Return original to festival coordinator two months prior to this event. <br />_______________________