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io; <br />11. <br />for rinsing and one for a bleachOR <br />I am providing the12. <br />booth during all hours of operation:14. <br />Important** <br />Completed by:15.DateTitleSignature <br />Health Permit <br />Paper Hand Towels <br />Soap dispenser <br />Cutting Board <br />BleachPropane Stove <br />Propane Tank <br />Bleach and Water.^■7 <br />Fire Extinguishera <br />Ice Cooler <br />TEMP EVENT APRPage 8 of 11EHD 16-02 <br />Stemo w/Chaffing <br />Dish <br />5-20 Gal. <br />Hand wash Water <br />Garbage <br />Can <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />Extra Ice Bags & Food Containers must be <br />stored 6 inches off of the ground! <br />Extra <br />Waler <br />5 Gal Hand wash <br />Wastewater Container <br />Sanitizer bucket­ <br />bleach & water for <br />storing wiping cloths <br />. — J - - ’n the b00th 3t 311 h0UrS Of <br />ation and operation. Return original to festival coordinator three weeks prior to <br />'ent <br />- f <br />Soap and Water Rinse Water <br />Ice chests O Refrigerator <br /> Refrigerated truck . r Ice bath and tubs <br />[^fother (specify) 9 ------------------- - <br />I am providing the following items within my booth for warewashing: <br /> Three compartment sink. <br />EfThree deep tubs (basins 6-8 inches minimum), one for soapy water, one <br />solution (one tablespoon of bleach per gallon of water). <br />following items within my booth for the sanitary cleaning of food preparation utensils: <br />Detergent, bleach, wiping cloths (cleaning towels), and a tub to store wiping cloths in bleach solution <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 />Names of responsible jersons^to be present in <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 i.. *J.s hizf-. ; <br />prepai <br />this <br />13 I am providing the following for adequate hand washing facilities, but separate from utensil wash within my booth: <br />container.