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<br />10. <br />11. <br />OR <br />□ Tub to store wiping cloths in bleach solution. <br />12. <br />□ One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />□ Paper towels and pump-style soap container. <br />Names of responsible persons to be present in booth during all hours of operation:13. <br />**lmportant** <br />Completed by. 14.d- <br />IHealth Permit <br />Paper Hanc Towels <br />Cutting Board <br />Propane Steve <br />r- <br />Propane Tank <br />Bleach and WaterSoap and Water <br />Fire Extinguisher <br />Ice Cooler <br />TEMP EVENT APPPage 8 of 11EHO 16-02 <br />08/01/16 <br />□ Ice chests <br />□ Refrigerated truck <br />□ Other (specify) <br />f ’ <br />1 <br />Extra ice Bags & Food Containers must be <br />stored 6 inches off of the ground! <br />Sterno w/Cheffing <br />Dish <br />5 Gai Hand wash <br />Wastewater Container <br />Garbage <br />Can <br />Sanitizer ouc-kei- <br />bleach & water for <br />storing wiping cloths <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <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 />"S/ Detergent, bleach, and wiping cloths (cleaning towels). <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br />Three compartment sink. <br />5-20 Gal. <br />Hand wash 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 />Refrigerator <br />□ Ice bath and tubs <br />DateTitle <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 /> <br />Cy Signature S' j <br />!''r~~lT=F=tb. f ...Ty7....XZ.;...\ .a: <br />Rinsa Water <br /> J Soap disperser | <br />III <br />I Bleach <br />Extra <br />Waist