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10. <br />11. <br />OR <br />□ Tub to store wiping cloths in bleach solution. <br />12. <br />13. <br />Completed by: 14./ii/i <br />/DateTitleignature <br />I <br />Paper Hand Towels <br />Soap dispenser <br />Cutting Board <br />BleachPropane Stove <br />•I <br />Bleach and WaterSoap and Water <br />Fire Extinguisher <br />Ice Cooler <br />TEMP EVENT APPPage 8 of 11 <br />. <br />Propane Tank / <br />EHD 1^-02 <br />08/01/16 <br />□ Ice chests <br />□ Refrigerated truck <br />□ Other (specify) <br />Sterno w/Chaffing <br />Dish <br />A copy of this checklist must be in the booth at all hours of <br />Return original to festival coordinator three weeks prior to <br />Extra <br />Water <br />5 Gal Hand wash <br />Wastewater Container <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 />Ct/........■' <br />l ' <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 />I am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br />Three compartment sink. <br />1----------------------------------------------------------------------------------------\ _______________ ___________________________________ <br />All food vendor booths are subject to inspection. Please make a copy of this application in <br />preparation for this event, <br />preparation and operation. <br />this event. <br />Rinse Water <br />r <br />-'If <br />"Important** <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 />II <br />1 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 />□ One separate tub (bucket or basin) for^the collection of rinse/wastewater. <br />□ Paper towels and pump-style soap container. <br />.■ A / <br />Names of responsible persons to be pre’$,dnt in booth during all hours of operation: <br />Extra lc& Bags & Food Containers must be <br />stored 6 inches off of the ground! L j <br />| Health Permit | <br />Garbage <br />Can