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10.I <br />11.I <br />□ Three compartment sink. <br />OR <br />[J Detergent, bleach, and wiping cloths (cleaning towels). <br />El i est strips to measure sanitation levels for bleach solution measuring lOOppm. <br />[ZJ i ub to store wiping cloths in bleach solution measuring 100ppm. <br />12. <br />-IBWater supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />SOne separate tub (bucket or basin) for the collection of rinse/wastewater. <br />3 Paper towels and pump-style soap container. <br />13. <br />Completed by:14. <br />DateSignature <br />Paper Hand Towels <br />Soap dispenser <br />Cutting Board <br />BleachPropane Stove <br />Propane Tank <br />Bleach and WaterSoap and Water <br />0 <br />ice <br />TEMP EVENT APRPage 8 of 11)2 <br />/Rinse Water <br />EHD 16- <br />8/1/14 <br />f3"lce chests <br />[J Refrigerated truck <br />[J Other (specify)__ <br />(3-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 />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 />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 />Stemo w/Chaffing <br />Dish <br />□ Refrigerator <br />£3-lce bath and tubs <br />5 Gal Hand wash <br />Wastewater Container <br />Garbage <br />Can <br />Sanitizer bucket­ <br />bleach & water for <br />storing wiping cloths <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, ora Tarp. <br />5-20 Gal. <br />Hand wash Water <br />Dooler ; <br />____1 <br />Title <br />Extra Ice Bags & Food Containers must be <br />stored 6 inches off of the ground! <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />am providing the following items within my booth for the sanitary' cleaning of food preparation utensils: <br />; "Important** <br />Names of responsible persons to be present in booth during all hours of operation: <br />/ S <br />He alth Permit - <br />L <br />Fire Extinguisher