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FOOD VENDOR PERMIT APPLICATION Page 2 <br />10. <br />11.I am oviding the following items within my booth for the sanitary cleaning of food-preparation utensils: <br />12. <br />13. <br />14.Completed by: <br />Health Permitinxiofi Bootfi <br />No Smoking Stgn <br />Paper Hand Tov«ts <br />[Cutting Board <br /> <br />Propane Tank <br />Soap and Wafer Beach and Water <br />Fire Exfinguislter <br />Ice Cooler <br />vendGr5@SanJoaqvinAspara8iisFestival.net • 916-370-3647 phone • 209-234-1780 faxPage 2/2 Rev 10/14/2015 <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 />□ Ice chests <br />Q Refrigerated truck <br />Q Other (specify): <br />ITT Three compartment sink. <br />F] Two deep tubs (basins 6-8 inches minimum), one for soapy water, the other for rinse and bleach solution. <br />[J 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 />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 />Paper towels and pump-style soap container. <br />[j Refrigerator <br />□ Ice bath and tubs <br />Garbage <br />Can <br />Must be on <br />Concrete, Asphalt. <br />Plywood or a Tarp <br />5 Ga! Hand Wash <br />Waste Water Container <br />Stemo twOtaffing <br />Dish <br />2-1/2 Gal. <br />Hand Wash Waler <br />Extra Ice Bags must be stored oft <br />of the ground' <br />Food Containers must be stored <br />off rhe floor! <br />Q <br />/ <br />I Soap Dispenser <br />Names of responsible persons to be present in booth during all hours of operation: <br />I am providing the following cold temperature control for the cold holding of potentially hazardous foods <br />below 45° F: ! <br />ick 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 ail hours of preparation and operation. <br />Return original to festival coordinate two months prior tqf this event <br />j ______________ <br />/ / Signature/Tttle / <br /> Bleach