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10.potentially hazardous foods below <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 100ppm. <br />□ Tub to store wiping cloths in bleach solution measuring 100ppm. <br />J <br />12. <br />'ater 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 />14.Completed by: <br />Sign.e <br />Paper Hand Towels <br />Soap dispenser <br />Cutting Board <br />BleachPropane Stove <br />Propane Tank <br />Rinse Water Bleach and Water <br />Fire Extinguisher <br />Ice Cooler <br />Page 8 of 11 TEMP EVENT APPEHD 16-02 <br />11/4/14 <br />I am providing the follow' <br />45°F (if food is used the <br />L\J 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 />Extra Ice Bags & Food Containers must be <br />stored 6 inches off of the ground I <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 />Slemo w/Chaffing <br />Dish <br />□ Refrigerator <br />□ Ice bath and tubs <br />5 Gal Hand wash <br />Wastewater Container <br />Garbage <br />Can <br />Booth must be on <br />Concrete. Asphalt, <br />Plywood, or a Tarp <br />Sanitizer bucket­ <br />bleach & water for <br />storing wiping cloths <br />Extra <br />Water <br />Title <br />-------- <br />Soap and Water <br />old temperature control for the cold holdin <br />iwiiowing day, maintain below 41 °F temperature/. <br />Names of responsible persons to be present in booth during all hours of operation: <br />h _______________________ <br />Health Permit <br />5-20 Gal <br />Hand wash Water