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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 />□ Three compartment sink. <br />OR <br />□ Detergent, bleach, and wiping cloths (cleaning towels). <br />□ Test strips to measure sanitation levels for bleach solution measuring lOOppm. <br />Q 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 />“Important** <br />14.Completed by: <br />Health Permit <br />Paper HonflToweU <br />1Cutting Board <br />DleazrPrepare Steve <br />I <br />eitarr anc Waler <br />Piro Exangxaher <br />Ice Cooler <br />Paga 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 />□ 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 />□ Refrigerator <br />□ Ice bath and tubs <br />Extra <br />Wator <br />5 Gai Hand *«»n <br />Waslowaier Container <br />Garbage <br />Can <br />Booth must be on <br />Concrete. Asphalt. <br />Plywood, or a Tarp <br />SanrfZBf buoet Weacti & water lor <br />ttortng wtpmg dorrs <br />J Propane Tank —=r- <br />Soao and Water Rn*e Water <br />| Scac aspenser <br />5-20 Gal <br />Hand wash Water <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 /> <br /> Signature Title Date // <br />&rra ice Bags 4 Fooc Containers must 0o H <br />jfor»d6M>cr>fl5Offo/rf>eprourW ■ <br />Slemo'w/Criatflng <br />Drsn