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10. <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensils:11. <br />Q Three compartment sink. <br />OR <br /> Detergent, bleach, and wiping cloths (cleaning towels). <br /> Test strips to measure sanitation levels for bleach solution measuring 100ppm. <br />Q Tub to store wiping cloths in bleach solution measuring lOOppm. <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. <br />“Important** <br />£Completed by: 14. <br />Signature fe <br />Health Permit <br />Piper Hond Tow«U <br />Prepare Stove <br /> £ <br />Beecr one Water <br />Fire ExBnouitherQ <br />TEMP EVENT APPPage 8 of 11EHD 16-02 <br />11/4/14 <br />I am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br />45OF (if food is used the following day, maintain below 41 °F temperature): <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 /> Refrigerator <br /> Ice bath and tubs <br />5 G«l Hand wb in <br />Wailovriier Corrtamor <br />Garbage <br />Can <br />Saniuzer buoat <br />pieacn 4 water for <br />itonng w>pw»g Ootni <br />Booth must be on <br />Concrete. Asphalt. <br />Plywood, or a Tarp <br />tea Bayj 3 Food Container mutt oa <br />storv) 6 fncrwj on of me prountf ' <br />Stamo w/Chaftlng <br />Dun <br />5-20 Gal <br />Hand wash Water <br />/Q Ice chests <br />iXEjRefrigerated truck <br /> Other (specify) <br />r———-Ice Cooler <br />Soso and Water Rirrae Water <br />Scao dupaniar <br />I ProDana Tank <br />Cutting Scare | <br />'Date <br />Names of responsible persons to be present in booth during all hours of operation: <br />or ____________________ <br />All food vendor booths^fe^ObJecrto-iqspection. Please make a copy of this application in <br />preparation for this/e^ent. 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 \