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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 />□ Tub to store wiping cloths in bleach solution measuring 100ppm. <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 />0 Paper towels and pump-style soap container. <br />13. <br />••Important** <br />Completed by: C14. <br />TitleSignature <br />Health Permit <br />Papw HontJTcwtij <br />] <br />Prepare Slavs <br />it <br />Propane Tank <br />OmcT and Water <br />Pee ExOngutther <br />Ice Cooler <br />TEMP EVENT APPPaso 8 cf 11 <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 />□ 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 />Erin loo Bags S Food Conttmors must Da <br />ifond 5 mcftes dh of the grouocf <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 />Slerno w'Cneffing <br />5 Gai wand wash <br />Wastewatar Conuww <br />Garbage <br />Can <br />Booth must be on <br />Concrete. Asphalt. <br />Plywood, or a Tarp <br />EHD 18-02 <br />11/4/14 <br />Extra <br />Water <br />Saniwar Bucket, <br />bleach 4 watar for <br />atonnfl wrpmg Sors <br />be l-Ot'I'LUt; <br />DateJ <br />—=F <br />Soao ard Water <br />5 <br />R. me Water <br />Names of responsible persons to be present in booth during all hours of operation: <br />_____ <br />Scap dispenser <br />V be I n e\ <br />Cutting Scare <br />I Bmai <br />□ Ice chests <br />□ Refrigerated truck <br />S' Other (specify) <br />5-20 Gai <br />Hand wash Water <br />□ Refrigerator <br />□ Ice bath and tubs <br />■ (\