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10. <br />11. <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 100T (i.e. 5-20 gallon container with spigot). <br />!$oan container. <br />13. <br />■fjt Co-OuiM^ <br />Signature Tltta Da$fe / <br />14.Completed by: <br />Health Permit <br />Pap* Hand ToweB <br />Curing Board <br />Proparm <br />Bleach end WaWr <br />Fte ExOngjiahN <br />Page Sot 11 TEMP EVENT APP <br />5 Gel Hand wash <br />W,«i >i»«f i Coroner <br />amKxT CMOS* <br />Uwch & warir <or <br />riw*<o <**pa>Q do* a <br />EHD 18-02 <br />7/28/10 <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />□ Ice chests <br />□ Refrigerated truck <br />□ Other (specify) <br />Stomo rwdiartng <br />Duh <br />□ Refrigerator <br />Q Ice bath and tubs <br />Extra <br />WatM <br />Garbage <br />Can <br /> Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />Extm lew 4 Rood Contaam's mva h« <br />nonce o/VHyovM' <br />I am providing the following Herns within my booth for the sanitary cleaning of food preparation utensils: <br />'^_Three compartment sink. <br />O 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 /> <br />| Prapand T»k <br />| Seep <br />“Important4* <br />I <br />Soap a>xl W«e< <br />r_z <br />f5ne» Water <br />5-20 Ort <br />Hand weah Water <br />______________7 I <br />Ice CoolerJJ <br />□ One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />Ip^aper towels and pum <br />Names of respopslble persons to be present In booth during aH hours of operation:____£5iui// fA \ U /Xk rYloOrc-^_______ <br />Ail food vendor booths are subject to inspection. Please make a copy of this application in <br />preparation for this event A copy of this cheddisi must be in the booth at all hours of <br />preparation and operation. Return Original to festival coWmatpr three weeks prior to <br />this event <br />I am providing the foltowing cold temperature control for the cold holding of potentially hazardous foods below <br />45°F (if food is used the following day, maintain below41 °F temperature): . / n,A//r