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9 uraous fooo& cei. <br />9 i am providing tne following items within my Dootn fo' the sanitary cleaning of fcoo preparation utensils <br />OR <br />^Z'fub to store wiping cloths in bleach solution <br />10 <br />t^aper towels and pump-style soap container <br />Names of responsible oersons to13 <br />■•(mportanr* <br />04^Completed by <br />iignature <br />Health Permit <br />i <br />I <br />Ice Cooter <br />•• MO EMEN? <br />[ <br />I <br />V; Three deep tubs (basins 6-8 inches minimum) one for soapy water one for rinsing and one fo' a bleach <br />solution tone tao espoon of bleach per gallon ot watet i <br />^^etergent. bleach, ano wiping cloths vcleaning towels <br />I am providing the following for adequate hand washing facilities but separate from utensil wash within nr, <br />booth <br />vf Water supply dispense' with warm water at a minimum of 100 F lie 5-20 gallon container with spigot' <br />VX>ne separate tub < bucket or basmi for the collection o' nnse.'wastewate' <br />: Refrigerator <br />" Ice bath and tubs <br />2L Ice chests <br />~ Refrigerated truck <br />;_j Other (specify . <br />-> — ■•an i : -3,^. <br />Booth 'hi ill oc ■ >r <br />Concreie Aspnati <br />hwcc.-i j< -I ~a:t <br />-•< >6 02 <br />’C >3 OS <br />r _Z <br />Q Three compartment sinr. <br />iresent in booth during all hours of operation & <br /> <br />Ail food <br />preparation for this event <br />preo^ratior and operation <br />th/ event, ri / <br />y ° It A <br />•naor bootns^re suOiect/6 inspection Please mate a copv of this aoDl-catior m <br />A copy of this checklist must be m the booth at all hours ot <br />Return original to festival coordinator three weeks prior to <br />■vi'” it uaibd'-ie <br />j <br />1 am providing the foi j cold temperature control for tne cold holding nt potentially <br />45'F lit food is used the following day maintain beiow 41 r temperan;'- <br />Titfe