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sntially hazardous foods below10. <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensils:11. <br />□ Three compartment sink. <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 100°F (i.e. 5-20 gallon container with spigot). <br />□ One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />□ Paper towels and pump-style soap container. <br />13.ames of responsible p< <br />Helen .Vi(|g.v^U t t <br />Completed b; 14. <br />DateSignature <br />Health Permit <br />Paper Hand Towels <br />Soap disperser <br />Cutting Beard <br />BleachPropane Sto\e <br />Z <br />Bleach and WaterRinse Water <br />Fire ExtinguisherQ <br />TEMP EVENT APPPage 8 of 11EHD 16-02 <br />49/12 <br />M Ice chests <br />□ Refrigerated truck <br />□ Other (specify) <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 />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />Stamp w/Chaffing <br />Dish <br />Extra <br />Water <br />5 Gal Hand wash <br />Waste-water Container <br />Garbage <br />Can <br />Sanitizer bucket­ <br />bleach S water for <br />storing wiping cloths <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />Names of responsible persons to be present in booth during all hours of operation: <br />Extra fce Bags S Food Containers must be <br />stored 6 inches off of the ground' <br />5-20 Gal <br />Hand wash Water <br />Title <br />/ ..y <br />Soap and Water <br />Propane Tank <br />-------------------? <br />IM <br />Ice Cooler <br />□ Refrigerator <br />0lce bath and tubs <br />u iy l aj /u <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 />preparation and operation. Return original to festival coordinator three weeks prior to <br />this event <br />**lmportant’ <br />I am providing the following c smperature control for the cold holding o <br />45°F (if food is used the following day, maintain below 41’F temperature):