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Completed by: <br />DateTitbSignature <br />Health Permit <br />Paper Hand Towels <br />Soap dispenser <br />Cutting Board <br />BleachPropane Stove <br />ItIPropane Tank <br />Bleach and WaterRinse WaterSoap and Water <br />Fire Extinquisher <br />Ice Cooler <br />TEMP EVENT APPPage 9 of 12 <br />It <br />Garbage <br />Can <br />EHD 16-02 <br />7/14/15 <br />Extra <br />Water <br />5 Gal Hand wash <br />Wastewater Container <br />Sanitizer bucket­ <br />bleach & water for <br />stonng wiping doths <br />Booth must be on <br />Concrete. Asphalt, <br />Plywood, or a Tarp. <br />Sterno w/Chaffing <br />Dish <br />k <br />15. <br />Extra Ice Bags & Food Containers must be H <br />stored 6 inches off of the ground1 ) <br />5-20 Gal <br />r- Hand wash Water