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10. <br />11. <br />OR <br />12. <br /> One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />13. <br />Completed by:14.Signature <br />Paper Hand Towels <br />Soap dispenser <br />Bleach <br />Propane Stow <br />n <br />Bleach end WaterRlnae Water <br />Fire Extinguisher <br />i <br />I <br />Extra <br />Waler <br />5 Gel Hand wash <br />Waslewaler Container <br />5-20 Gal. <br />Hand wash Water <br />Sanitizer bucket­ <br />bleach & waler for <br />storing wiping ctolht <br />Stemo wfChafTrng <br />Diah <br />J <br />Ice Cooler <br />omt <br />Title <br />“Important” <br />Garbage <br />Can <br />Propane Tank <br />/ <br />copy of this checklist must be in the booth at all hours of <br />7^. Return original to festival coordinator three weeks prior to <br />Date <br />Health Permit - <br />Extre Ice Begs I Food Conrehers must be <br />stored C Inches oltotthe ground! <br />— .twr <br /> Paper towels and pump-style soap container. <br />Names of responsible persons to be present in booth during all hours of operation. <br />-- ----------------------------- ----------------------------- <br />All food vendor booths are subject to inspection. Please make a “PY <br />preparation for this ever <br />preparation and operatioh. <br />this evepV~ <br />r> Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />Grrntnc!* <;rnus hern <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 /> Ice chests Refrigerator <br /> Refrigerated truck Ice bath and tubs <br /> Other (specify)____________ ________________________ <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br /> Three compartment sink. <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 /> Detergent, bleach, and wiping cloths (cleaning towels). <br /> Tub to store wiping cloths in bleach solution. <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br /> Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />I I <br />Soap and Water