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FOOD VENDOR PERMIT APPLICATION Page 2 <br />10. <br />11.I am providing the following items within my booth for the sanitary cleaning of food-preparation utensils: <br />12. <br />13. <br />14.Completed by:. <br />Signature/Title <br />10 X 10 ft. Booth Health PermitNo Smoking Sign <br />Paper Hand Towels <br />Soap Dispenser <br />Cutting Board <br />Bleach <br />Propane Stove <br /> 0 <br />Propane Tank <br />Soap and Water Bleach and Waler <br />Fire Extinguisher <br />Ice Cooler <br />V <br />vendors@SanJoaquinAsparagusFestival.net • 916-370-3647 phone • 209-234-1780 faxPage 2/2 Rev 10/14/2015 <br />□ Three compartment sink. <br />(vfTwo deep tubs (basins 6-8 inches minimum), one for soapy water, the other for rinse and bleach solution. <br />H^Detergent, bleach and water (one cap full per gallon of water). <br />lETlce chests <br />□ Refrigerated truck <br />[J Other (specify): <br />Stemo w/Chaffing <br />Dish <br />□ Refrigerator <br />□ Ice bath and tubs <br />5 Gal Hand Wash <br />Waste Water Container <br />Garbage <br />Can <br />Must be on <br />Concrete, Asphalt, <br /> Plywood or a Tarp <br />I am providing the following for adequate hand washing facilities, but separate from utensil washing <br />within my booth: <br />Heater supply dispenser (e.g. 5-20 gallons, Igloo or Coleman container with spigot). <br />[vl'tSne separate tub (bucket or basin) for the collection of rinse/waste water. <br />[vfl^aper towels and pump-style soap container. <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 />Extra <br />Water <br />2-1/2 Gal. <br />Hand Wash Water <br />Extra Ice Bags must be stored off <br />of the ground! <br />Food Containers must be stored <br />off the floor! <br />D <br />I am providing the following cold temperature control for the cold holding of potentially hazardous foods <br />below 45° F: <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 all hours of preparation and operation. <br />Return original to festival coordinator two months prior to this event. <br />Names of responsible persons to be,present in booth during all hours of operation: <br />A I 'C t-A. y <2, vyVL—