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10. <br />11.I am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br />□ Three compartment sink. <br />OR <br />□ Detergent, bleach, and wiping cloths (cleaning towels). <br />□ Tub to store wiping cloths in bleach solution. <br />12. <br />□ Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />□ One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />0 Paper towels and pump-style soap container. <br />13. Names of responsible persons to be present in booth during all hours of operation: <br />■SoshMA K, Rod > Beu K. <br />5/3114.Completed by: <br />Date <br />Paper Hand Towels <br />Culling Boerc <br />BleachPropane Stove <br />I <br />Rinse Water Bleach and Waler <br />L <br />Pago 8 of 11 TEMP EVENT APP <br />! <br />EHD 16-02 <br />08/01/16 <br />13 Ice chests <br />□ Refrigerated truck <br />□ Other (specify) <br />□ Refrigerator <br />□ Ice bath and tubs <br />Extra <br />Water <br />Sanitizer bucket­ <br />bleach & water for <br />storing wiping cloths <br /> Booth must be on <br />Concrete, Asphalt, <br />Plywood, ora Tarp. <br />Extra lea Bags & Food Coniafners must be <br />stored 6 Inches olfofUie ground! <br />5 Gal Hand wash <br />Wastewater Container <br />5-20 Gal. <br />Hand wash Water <br />Sterno v^Chaffing <br />Dish <br />-----------------IR <br />All food vendor booths are subject to Inspection. Please make a copy of this application in <br />preparation for this event. A copy of this checklist must be in the booth at all hours of <br />preparation and operation. Return original to festival coordinator three weeks prior to <br />this event. <br />Signature <br />Ice Cooler <br />Soap and Water <br />k. R.*- <br />J Title <br />| Propane Tank <br />**lmportant** <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />I Health Permit <br />□ Three deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br />solution (one tablespoon of bleach per gallon of water). <br />I am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br />45°F (If food is used the following day, maintain below 41 °F temperature): <br /> | Soap dispenser j —------ <br />I Fire Exflni^Jiahor <br />Garbage <br />Can