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8. <br />9.I am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br />Three compartment sink <br />OR <br />10. <br />^Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />13. <br />Completed14. <br />Signature <br />r <br />1 JHealth Permit <br />1 Paper Hand Towels <br />Cutting Board <br />rBleach <br />I <br />Propane Tank <br />Bleach and Water <br />J <br />TEMP E'/EMT APP <br />3 <br />! Extra \ <br />Water <br />L <br />1 <br />] <br />tHU 1&-U2 <br />10/13/09 <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 />preparatipfrafK^ operation. Return original tex festival coordinator three weeks prior to <br />this ev^nt. y <br />□ Refrigerator <br />□ Ice bath and tubs <br />5 Gal Hand wash <br />Wastewater Container <br />Garbage <br />Can <br />Sanitizer bucket­ <br />bleach & water for <br />storing wiping cloths <br />•f^One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />t^kPaper towels and pump-style soap container. <br />Names pf responsible persons to <br />I am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br />45°F (if fuud is used the following day, maintain beiow41::F temperature): <br />^Jlce chests <br />□ Refrigerated truck <br />□ Other (specify) <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />Sterno w/Chaffing <br />Dish <br />5-20 Gal. <br />Hand wash Water <br />rr <br />i <br />Fire Extinguisher <br />QfThree 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 />(/u N e-*: <br />Title <br />rr <br />Rinse Water <br />| Ice Cooler | <br />E^x^tergent, bleach, and wiping cloths (cleaning towels). <br />I "T* ■ > 1—• 4 1 ■ •• ^.4L« —' . L* I m Uw I • .4.I zr~4 UM IM oruic wiping UIUUIO III UICOUII oviuiimii. <br />r*--------- .c 4 arciyc u vi ii <br />“Important** <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />_________________7 <br />./ I <br />7- / I v <br />f Date <br />I Soap and Water | | <br />I Praoane Stove I « <br />I| 1 <br />Extra Ice Barrs & Food Containers must be H <br />stored 6 inches oH of the ground' K <br />ies pf responsible persons to be present in booth during all hours of operation. <br />> cxr o. De k <br />Extra <br />Water