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0002/00203/21/2016 16:18 FAX <br />Page 2FOOD VENDOR PERMIT APPLICATION <br />10. <br />11. <br />12. <br />13. <br />IMPORTANT <br />Health Permit1OX WU.DOGW No Swwttflf <br />Papg< <br />0 <br />Propene T*nK <br />7\F>« EMllngulerw <br />Pa©* 2/2 R»v 10/14/2015 <br />fflutffte etoretfoff <br />i nwsfbe won*? <br />I aw Hert W»*h <br />WmleWAerCorf*^ <br />2’i n ow. <br />Herat VWi WPMrf <br />Must bo on <br />Concrete, Asphalt, <br />Plywood or a Tarp <br />iter supply dispenser (e.g. 5-20 gallons, Igloo or Coleman container with spigot), <br />^separate tub (bucket or basin) for the collection of rinse/waste water. <br />per towels and pump-style soap container. <br />3ie<raj <br />DM <br />□ Refrigerator <br />□ Ice bath and tubs <br />EtVa <br />Garbage <br />Can <br />I am providing the following for adequate hand washing facilities, but separate from utensil washing <br />within my booth: <br />Ice Cooler <br />□ Three compartment sink. <br />g^Two deep tube (basins 6-B inches minimum), one for soapy water, the other for rinse and bleach solution. <br />.gJTletergant, bleach and water (one cap full per gallon of water). <br />I am providing the following cold temperature control for the cold holding of potentially hazardous foods <br />below 45" F: <br />ErtatogPew m. <br />FQMfborWMs <br />orv» fioarl <br />vendors@SanJoaquinAspaiagusFestival.net • 916-370-3647 phone • 209-234-1780 fax <br />Your hot & cold food temperatures will be monitored. Your hand washing and sanitation processes win <br />be checked. PLEASE meet the required standards as addressed herein. <br />Names of responsible person^ to be present in booth ckfrlng all hours of operation: <br />Af/zrY-zz. --------------- <br />SWP WWW | | w ww | <br />S4pa 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 />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 thia checklist must be in the booth at all hours of preparation and operation. <br />Beturn original to festival coordingtgrtwo. prior to this event. , <br />14. Completed by:(^ <br />I Cutting Bowd