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Signature <br />15.Completed by: <br />Title <br />Health Permit <br />Paper Hand Towels <br />Soap dispenser <br />Cutbnq Board <br />BleachPropane Stove <br />IPropane Tank LIBleach and WaterSoap and Water Rinse Water <br />Fire Extinquisher <br />Ice Cooler <br />Page 7 of 9 TEMP EVENT APP <br />r <br />Garbage <br />Can <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />EHD 16-02 <br />7/14/15 <br />Sterno w/Chaffing <br />Dish <br />Extra <br />Water <br />5 Gal Hand wash <br />Wastewater Container <br />5-20 Gal. <br />Hand wash Water <br />Sanitizer bucket­ <br />bleach & water for <br />stonng wiping cloths <br />Date <br />Extra /ce Sags & Food Containers must be I <br />stored 6 inches off of the ground! >