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10. <br />11. <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 />□ Paper towels and pump-style soap container. <br />13.Names of responsible persons to be present in booth during all hours of operation: <br />14.Completed by: <br />Health Permit <br />Papw Hood ToweU <br />Scac <S>penMr <br />Beecr.Prepare Stove <br />it <br />Beecr and Water <br />Fee ExfingueherQ <br />Ice Cooler <br />Pago 8 of 11 TEMP EVENT APPEHD 10-02 <br />11/4/14 <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 />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />& fra toe Sage t Food Cantunen mutt De <br />sfo/ed fl inches oft of the gm>nd! <br />5 Gai Hand wash <br />Wastewater Container <br />Cartage <br />Can <br />Booth must be on <br />Concrete. Asphalt. <br />Plywood, or a Tarp <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br />Q Three compartment sink. <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 />Sleoo w/Chafflng <br />Oran <br />□ Refrigerator <br />^Alce bath and tubs <br />S-20 GM <br />hand Wator <br />Saniuzar Duoet <br />btoBcti i wotar tor <br />ttonng wipmg aor« <br />^0'lce chests <br />J^^efrigerated truck <br />□ Other (specify) <br />( Extra \ <br />Waur <br />Title <br />-—=F <br />Soap and Witsr <br />r <br />Rihm Water <br />‘•Important** <br />I Propane Tank <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 />J Signature <br />Cutting Beard |