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10. <br />I am providing the following items within my booth for warewashing:11. <br />S'Three compartment sink. <br />OR <br />12. <br />13. <br />14. <br />15. <br />Health Permit <br />Paper Hand Towe s <br />Soap disperser <br />Cutting Board <br />BleachPropane Stove <br />Propane Tank <br />Bleach and Water <br />Fire Extinguisher <br />F <br />Ice Cooler <br />Page 8 of 11 TEMP EVENT APP <br />Soap and Water <br />EKO 16-02 <br />7/14/15 <br />□ Ice chests <br />□ Refrigerated truck <br />□ Other (specify) <br />I am providing the following cold temperature control for the cold holding or potentially hazardous foods below <br />45°F (if food is used the following day, maintain below 41°F temperature): <br />5 Gal Hand wash <br />Wastewater Coniainer <br />Garbage <br />Can <br />Sanitizer bucket- <br />ttleacn & waler tor <br />storing wiping ciolhs <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 />Sterno w/Chaffing <br />Osh <br />[^Refrigerator <br />□ Ice bath and tubs <br />5-20 Gal <br />Hand wash Water <br />Extra <br />Water <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br />Q'Detergent, bleach, wiping cloths (cleaning towels), and a tub to store wiping cloths in bleach solution. <br />Date <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my booth: <br />H'Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). A <br />separate tub (bucket or basin) for the collection of rinse/wastewater. Paper towels and a pump-style soap <br />container. <br />Extra Ice Bags & Food Containers must ce K <br />stored 6 inches otf of the ground' i jl <br />7 <br />Rinse water <br />$65/ defr/ <br />Title <br />Names of responsible persons to be present in booth during all hours of operation:b flexes ______________ <br />“Important**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. n <br />Completed by: <br />77 SignatujX