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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 />all hours of operation:13. <br />;subje< <br />Completed by:_ft|14. <br />10 X 10 ft Booth <br />Paper Hand Towels <br />Soap Drspcnsor <br />Culling Board <br />Bleach <br />Propane Stove <br />\ <br />Soap and Water Bleach and Water <br />7\Fire Extinguisher <br />Ice Cooler <br />vendQrs@SanJoaquinAsparaflusFestival.net • 209-466-5041 phone ♦ 209-466-5141 faxPage 2/2 Rev 11/15/2014 <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 />[J Detergent, bleach and water (one cap full per gallon of water). <br />□ Water supply dispenser (e.g. 5-20 gallons, Igloo or Coleman container with spigot). <br />One separate tub (bucket or basin) tor the collection of rinse/waste water. <br />□ Paper towels and pump-style soap container. <br />□ Ice chests <br />□ Refrigerated truck <br />□ 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 />Sfsino w.'Chaffmg <br />Dish <br />Q Refrigerator <br />□ Ice bath and tubs <br />5 Gal Hand Wash <br />Wasta Water Container <br />Extra <br />Water <br />Garbage <br />Can <br />Must be on <br />Concrete, Asphalt, <br />Plywood or a Tarp <br />ydilrself a copy of this application in preparation for this <br />at/rl of prepar^isnTand operation. <br />tljig event. . —------- - <br />_______ <br />Health Permit <br />Names of responsible persons to be present in booV <br />Michael & Stephanie Comptofr_____/ <br />| i / <br />2-1.Gal <br />Hand Wash Waler <br />IMPORTANT i <br />All food vendor booths |p <br />event. A copy of this c||) <br />Return original to festlE <br />-| <br />I am providing the following cold temperature control for the cold holding of potentially hazardous foods <br />below 45° F: <br />I <br />Extra Ice Bags must be stored oft <br />of the groend! <br />Food containers must be stored <br />off the flood <br />No Smoking Slgo <br />I Propone Tank j <br />rlsubjei t tori ispecWr.1 Please nl <br />‘ Iklist ri usj ae in booth all <br />: ilcoorJ inaft >r tw«|pqnths priy AP p\ ! <br />Signature/Title