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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 />hree compartment sink. <br />OR <br /> Detergent, bleach, and wiping cloths (cleaning towels) <br /> Test strips to measure sanitation levels for bleach solution measuring 100ppm. <br /> Tub to store wiping cloths in bleach solution measuring lOOppm. <br />12. <br /> Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br /> One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />13. <br />‘•Important** <br />Completed by: 14. <br />Signature <br />Paper Hand Towels <br />Soap dispenser <br />Cuttina Board <br />SlaachPropare Stove <br />3! <br />Propane T ark <br />Beacn and Waler <br />F>re ExUnousfier <br />Ice Cooler <br />TEMP EVENT APPPage fl of 11 <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 /> 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 /> Refrigerator <br />j/ftee bath and tubs <br />5 Gal Hand wash <br />Wostawator Container <br />Garbage <br />Can <br />Santiier bucket <br />Bleach & watar tor <br />storing w ping doth! <br />Booth must be on <br />Concrete. Asphalt. <br />Plywood, or a Tarp <br />EHO 16-02 <br />IIM/14 <br /> Ice chests <br />tnjck <br /> Other (specify) <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />Stemo w/Oiaffing <br />Drsh <br />5-20 Gal <br />Hand wash Water <br />Extra <br />Water <br />Da <br />0 <br />| Health Permit <br />/P/TPaper towels and pump-style soap container. <br />Names of responsible persons to be present in booth during all hours of operation: <br />______ <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 operation. Return original to festival coordinator three weeks prior to <br />this event ✓—\ <br />■sdarir <br />Soap and Waior Rinso Wator <br />Exira tea Sags 4 Food Contamerj must De ■ <br />stored 8 inches off of Iho ground1 Wil