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10. <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensils:11. <br />□ i hree compartment sink. <br />OR <br />S Detergent, bleach, and wiping cloths (cleaning towels). <br />□ Tub to store wiping cloths in bleach solution. <br />12. <br />Q Water supply dispenser with warm water at a minimum of WOT (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-stvle soap container. <br />13. <br />'’Important*" <br />3Completed by.14. <br />gnat <br />Health Permit <br />Paper Hand Towcts <br />Soap drtpcnocr <br />2c5chPropano Skvc <br />Propane Tank <br />Bleach and WaterSoap and Water <br />Piro Bdinpuisherff <br />Ice Cooler <br />Page 8 of 11 TEMP EVENT APP <br />Rinse Water <br />EH016-G2 <br />7Z2»10 <br />Names of responsible persons to be present in booth during all hours of operation: <br />Heather Fogle_____________________________________ <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <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 />El Ice chests <br />□ Refrigerated truck <br />□ Other (specify) <br />□ Refrigerator <br />□ Ice bath and tubs <br />Garbage <br />Can <br />5 Gal Hand wash <br />Woatewnter Container <br />Sanitizer txxkct- <br />Wwctiiwattrfor <br />ctortng wiping cloths <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, ora Tarp. <br />Stemo w/Chaftng <br />Dish <br />Extra <br />W3»r <br />Title 3 ate <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 in the booth at all hours of <br />preparation and ^per^ion. Return original to festival coordinator three weeks prior to <br />this event <br />5-20 Gel <br />Hand wach Water <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 />Ex'jxi Ico Soys & Food ConlarKn must Do Kj <br />I storod 6 tnctxB cFT of the ground! t_l