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10. <br />11. lam providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br /> Three compartment sink. <br />OR <br />EB-fh <br />Q-Oetergent, bleach, and wiping cloths (cleaning towels). <br />12.my <br />13. <br />14.Completed byi <br />Signature <br />Health Permit <br />Paper Hand Towels <br />Soap disponsor <br />Cutjing Board <br />Propane Stove Bloach <br />n p iI I * II <br />Rinse Water <br />Piro Extinguisher <br />Ice Cooler <br />Page 8 of 11 TEMP EVENT APPEHD 16-02 <br />11/4/14 <br />ETest strips to measure sanitation levels for bleach solution measuring 100ppm. <br />[flTub to store wiping cloths in bleach solution measuring 100ppm. <br />QTIne separate tub (bucket or basin) for the collection of rinse/wastewater. <br />[p Paper towels and pump-style soap container. <br />Extra Ice Bags & Food Containers must be <br />stored 6 inches off of the ground! <br />Stemo w/Chaffing <br />Dish <br />5 Gal Hand wash <br />Wastewater Container <br />Extra <br />Water <br />5-20 Gal. <br />Hand wash Water <br />Sanitizer bucket­ <br />bleach & water for <br />storing wiping clothsI <br />Title Date <br />Soap and Water <br />Names of responsible persons to be present in booth during all hours of operation: <br />**lmportant**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 />ree 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 />---------------------Booth must be on <br />Concrete. Asphalt. <br />Plywood, or a Tarp.* —• —I L ■/ <br />Bleach and Water | <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within <br />booth: <br />ElM/ater supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />Propane Tank ------------------------i <br />■—-- <br />Garbage <br />Can <br />' the followin9 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 />ffilcTchests □ Refrigerator <br /> Refrigerated truck j^ptTe bath and tubs <br />Q-Otier (specify) /feuOtkVG ____________