Laserfiche WebLink
10. <br />I am providing the following Hems within my booth (ortho senftory cleaning of food preparation utensils:11. <br />OR <br />12. <br />13. <br />14. Completed by: <br />Signature <br />Health Permit <br />Paper Hand TWfcfe <br />Soap dispenser <br />CiAJnfl Board a BieachPropiiW StWd <br />f IE H.n <br />Flic EririgulsherG <br />Ice Cooler <br />rewp EVENT AFPPs&e&of 11 <br />Z0/Z0 B9Vd saawwns EZESEZS60Z t>T0Z/TT/30Wd00:E0 <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <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 />CankTzM boekeT- <br />bltjkki&'Mte'for <br />srorw W< ns «>••»«» <br />EHD 1602 <br />7129110 <br />^AWater supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />gpDne separate tub (bucket or basin) for the collection of rinse/wasfewater. <br />Q Refrigerator <br />□ Ice bath and tubs <br />5 Mdth <br />W&rtewa*» ConteJner <br />5-20 <br />H?miw*shWefci <br />6torna oy» <br />f Gitra \ <br />Wahtf I <br />J <br />’“Important** <br />Booth must be on <br />concrete, Asphalt, <br />Plyvrood, ora Tarp. <br />. .J <br />Garbage <br />Can <br />Mlhree 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 />^Detergent, bleach, and wiping cloths (cleaning towels). <br /><t5£rub to store wiping cloths in bleach solution. <br />□ Ice chests <br />□ Refrigerated truck , <br />Other (specify) \ <br />Extra kt Bait t Foot Canteiiers rrusH* <br />PropgnflTanR <br />^[paper towels and pump-style soap container. <br />Names of responsible persons to be present in booth during all hours of operation: <br /> gl J LA _______________________ <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 />bate