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FOOD VENDOR PERMIT APPLICATION Page 2 <br />10. <br />11.I am providing the following items within my booth for the sanitary cleaning of food-preparation utensils: <br />12. <br />i A <br />13. <br />1 <br />10X 10ft. Booth <br />Paper Hand Towels <br />Bleach <br />0 <br />Soap and Water <br />Ice Cooler <br />vendors@SanJoaquinAsparagusFestival.net • 916-370-3647 phone • 209-234-1780 faxPage 2X2 Rev 10/14/2015 <br />J <br />□ Ice chests <br />JzLRefriqerated truck <br />□ Other (specify): <br />Garbage <br />Can <br />Must be on <br />Concrete. Asphalt, <br />Plywood or a Tarp <br />□ Three compartment sink. <br />□ Two deep tubs (basins 6-8 inches minimum), one for soapy water, the other for rinse and bleach solution. <br />fTf Detergent, bleach and water (one cap full per gallon of water). <br />Refrigerator <br />Ice bath and tubs <br />5 Gal Hand Wash <br />Waste Water Container <br />2-1/2 GaL <br />I land Wash WaterStemo w/'Chaffing <br />Dish <br />_______ <br />No Smoking Sign <br />j | Bleach and Water <br />/ Extra ' <br />I Water <br />I Soap Dispenser <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 />I am providing the following for adequate hand washing facilities, but separate from utensil washing <br />within my booth: <br />(7^ <br />I am providing the following cold temperature control for the cold holding of potentially hazardous foods <br />below 45° F: <br />-_____ <br />Extra fco Bags must bo stored off <br />of the ground! <br />Food Containers must be stored <br />Off the boor! <br />\ <br />0 <br />• ' <br />Health Permit <br />O Water supply dispenser (e.g. 5-20 gallons, Igloo or Coleman container with spigot). <br />Q One separate tub (bucket or basin) for the collection of rinse/waste water. <br />□ Paper towels and pump-style soap container. Vx - <br />Names of responsible persons to be present in booth during all hours of operation: <br /> YVx C<. 'AScvg I "V , L. J 3^'^ <br />I Cutting Board <br />Propano Stovo <br /> | Propano Tank I <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 />14. Completed by: / <br />y Signature^Titl^