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* <br />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 />Completed by:14. <br />10 X 10 ft Booth <br />Paper Hand Towcfe <br />Soap Dispenser <br />Cutting Soaid <br />Propane Stove <br />Propane Tank <br />Soap and Water Bleach and Water <br />Firo Extinguisher <br />Ice Cooler <br />vendors° SanJoaquinAsparagusFestivai.net • 209-466-5041 phone • 209-466-5141 faxPage Ul Rev 1 Vi 5/2014 <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 />□ Detergent, bleach and water (one cap full per gallon of water). <br />□ Ice chests <br />□ Refrigerated truck <br />Q Other (specify): <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 />£3 Refrigerator <br />□ Ice bath and tubs <br />Extra <br />Water <br />Garbage <br />Can <br />Must be on <br />Concrete. Asphalt, <br />Plywood or a Tarp <br />Siemo wChatfing <br />Disit <br />5 Gal Hand Wash <br />Was® Water Container <br />2-1/2 Gal <br />Hand Wash Water <br />Health Permit <br />IMPORTANT <br />All food vendor booths ( <br />event. A copy of this c| <br />Return original to festil <br />- <br />No Smoking Sign <br />I am providing the following cold temperature control for the cold holding of potentially hazardous foods <br />below 45° F: <br />Extra fee Sags must stored on <br />of the wvijHi! <br />Food Contaitieis must be stored <br />of? the fioof' <br />□ Water supply dispenser (e.g. 5-20 gallons, Igloo or Coleman container with spigot). <br />O One separate tub (bucket or basin) for the collection of rinse/waste water. <br />□ Paper towels and pump-style soap container. <br />Names of responsible persons to be present in bootnldurimf all hours of operation: <br />Michael & Stephanie Coinptofi II // <br />11 subje< t toll ispec'l Please nt4 e yai rself a copy of this application in preparation for this <br />■ ‘ Iklist i lus] 3e in f I booth at nil hodr i of preparaJj>nTand operation. <br />A t icoorflinaft >r tw« ricyiths pridrKo ttfis event. . —-------- -Bmftnffiriirzz <br />Signature/Title