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10. <br />11. <br />OR <br />•etergent, bleach, and wiping cloths (cleaning towels). <br /> Tub to store wiping cloths in bleach solution. <br />12. <br />13. <br />14.Completed by: <br />lature Title <br />Paper Hand Towels <br />Propane Stove Bleach <br />Fire Extinguisher <br />Page 8 of 11 TEMP EVENT APP <br />Ewce chests <br /> Refrigerated truck <br /> Other (specify) <br />Stemo w/Chaffing <br />Dish <br />Extra <br />Water <br />5 Gal Hand wash <br />Wastewater Container <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />[✓H^efrigerator <br /> Ice bath and tubs <br />Ice Cooler i-------L <br />EHD 16-02 <br />7/28/10 <br /> f"/.';«l fairs <br />..k-.,....... <br />Names of responsible persons to be present in booth during all hours of operation: <br />V>€A La r r~a c> <br />"Important** <br />______________ <br />i. Please make a copy of this application in <br />Rinse WaterSoap and Water <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 />Propane Tank <br />----------------------S <br />| ' Health"permit~ <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br /> Three compartment sink. <br />^^B^fhree 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 />_______A~ 1 -c br M <br />All food vendor booths are subject to inspection. <br />preparation for this event. A copy of this checklist must be in the booth at all hours of <br />preparation and operation. Return ofiqinal to festival coordinator three weeks prior to <br />this event. \ <br />5-20 Gal. <br />r- Hand wash Water <br />h\ <br />1^ aim providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />.EfWater 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 />^Q^aper towels and pump-style soap container. <br />I Soap dispenser <br />I' 15 <br />Date <br />Extra Ice Bags & Food Containers must be m <br />stored 6 inches off of the ground! h| <br />Cutting Board / Sanitizer bucket- <br />/ _ bleach & water for <br />/ I storing wiping cloths <br />o r <br />C <br />Garbage <br />Can