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Page 2FOOD VENDOR PERMIT APPLICATION <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 />Health Permit10 X 10 ft. Booth <br />No Smoking Sign <br />Paper Hand Towels <br />Soap and Water BcacJi and water <br />Ice Cooler <br />Psse Rev 10/14/2015 <br />□ Ice chests <br />-£9 Refrigerated truck <br />□ Other (specify): <br />[J, Three compartment sink. <br />□ Two 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 />Stcmo w.'CtKi'fing <br />CSsh <br />Q Refrigerator <br />□ Ice bath and tubs <br />5 Gai Hand Wash <br />Waste Water Container <br />Extra <br />Water <br />Must be on <br />Concrete, Asphalt, <br />Plywood or a Tarp <br />Names of responsible persons to be present in booth during all hours of operation: <br />____I cov ShrVizci/ _ ____________________ <br />2-1/2 Gal. <br />Hand Wash Water <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 />QZ7 <br />Propane Tank <br />I am providing the following cold temperature control for the cold holding of potentially hazardous foods <br />below 45° F: <br />Fire I <br />Extra Ice Sags must be stored oft <br />of the ground! <br />Food Cora»ners must be stored <br />of! the Soar! <br />vendors@SanJoaquinAsparagusFestival.net ■ 916-370-3647 phone • 209-234-1780 fax <br />Soap Dispenser <br />IMPORTANT <br />All food vendor booths are subject to inspection. Please make yourself a copy of this application in preparation :or 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: T-— ( ------I'V «• > A < z / ----------------------------------------------------- <br />Signature/Title <br />I am providing the following for adequate hand washing facilities, but separate from utensil washing <br />within my booth: ? CO <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 />Q Paper towels and pump-style soap container.