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Page 2FOOD VENDOR PERMIT APPLICATION <br />10. <br />11. <br />12. <br />13. <br />i <br />IMPORTANT <br />14. <br />Health Permit10 X 10 ft. Booth <br />No Sr^oX '••g S'gn <br />Paper Hand To .veis <br />Cutting Board <br />Soap and V/a'.er <br />Fire Extngu SherD <br />Ice Cooler <br />Page 2-2 Rev 10/142015 <br />Stemo w/Cha“ing <br />D sh <br />□ Refrigerator <br />Q Ice bath and tubs <br />Extra <br />Water <br />2-V2 Gal <br />Hand Wash Water <br />Must bs on <br />Concrete, Asphalt. <br />Plywood or a Tarp <br />s Gal Hand Wasn <br />Waste Water Cmta ner <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 />Garbage <br />Can <br />J Prepane Stove <br />I am providing the following cold temperature control for the cold holding of potentially hazardous foods <br />below 45° F: <br />□ Three compartment sink. <br />J2pwo 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 />I am providing the following for adequate hand washing facilities, but separate from utensil washing <br />within my booth: <br />j | sieacn and Waler | <br />I Sc-ap 0 spenser <br />I Bleach <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 festal coordinator two months prior to this event <br />Com pleted by: '____fl-7! t c<_ <br />Signature/Title ' <br />(3 Ice chests <br />□ Refrigerated truck <br />□ Other (specify): <br />I am providing the following items within my booth for the sanitary cleaning of food-preparation utensils: <br />Propg-se Tank I <br />[3] Water supply dispenser (e.g. 5-20 gallons, Igloo or Coleman container with spigot). <br />One separate tub (bucket or basin) for the collection of rinse/waste water. <br />£V£'Paper towels and pump-style soap container. <br />Names of responsible persons to be present in booth during all hours of operation: <br />E*?ra ice Bags rr.usi te sx-^ed c* <br />cf the ground1 <br />Food Ccn'.a ncrs musi te stored <br />otfF.e V'ccr' <br />ventfors@SanJoaquinAsparagusFestival.net ■ 916-370-3647 phone • 209-234-1780 fax