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8. <br />9. <br />OR <br />□ Detergent, bleach, and wiping cloths (cleaning towels). <br />□ Tub to store wiping cloths in bleach solution. <br />10. <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 />fl Paper towels and pump-style soap container. <br />13. <br />Completed by: 14. <br />Health Permit <br />Paper Hand Towels <br />Soap dispenser <br />Cutting Board <br />BleachPropane Stove <br />Rinse Water Bleach and Waler <br />Fire Extinguisher <br />Ice Cooler <br />TEMP EVENT APPPage 8 of 11EHD 16-02 <br />10/13/09 <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br />®Three compartment sink. <br />fl] Ice chests <br />□ Refrigerated truck <br />□ Other (specify) <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 />0 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 />[~| Refrigerator <br />□ Ice bath and tubs <br />5 Gal Hand wash <br />Wastewater Container <br />Garbage <br />Can <br />Booth 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 wash within my <br />booth: <br />Stemo w/Chaffing <br />Dish <br />Extra <br />Water <br />5-20 Gal <br />Hand wash Water <br />Sanitizer bucket­ <br />bleach & water for <br />storing wiping cloths <br />& <br />Extra Ice Bags & Food Containers must be B <br />I stored 6 inches on of the ground! ■ <br />Title <br />Propane Tank <br />______________J <br />rw...- <br />Date <br />■Mm .I I <br />B Soap and Water <br /> <br />‘•Important** All food vendor booths are subject to inspection. Please make a copy of this application in <br />preparation for this event. A oopy of this checklist must be in the booth at all hours of <br />preparation and opefatitffi. Rinurn original to festival coordinator three weeks prior to <br />this event.