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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 />□ Three 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 />□ Water supply dispenser with warm water at a minimum of 100GF (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-style soap container. <br />13. <br />••Important** <br />UcCompleted by: 14. <br />Signature <br />Health Permit <br />Paper Hard Towelj <br />Soap dilponier <br />Cuaing Board <br />BleactiPropora Stove <br />f <br />Propane Tank <br />Rinse WaterSoap and Waler <br />a Fire EannguVW <br />Ice Cooler <br />TEMP EVENT APPPage a of 11EHD 16-02 <br />IIM/14 <br />□ Ice chests <br />□ Refrigerated truck <br />□ Other (specify) <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 />Eitra Kv Bags i Food Containers must be <br />stored 0 monos oftoflbo ground' <br />Stemo w/Chatflng <br />Dish <br />□ Refrigerator <br />□ Ice bath and tubs <br />Eitra <br />Water <br />Garbage <br />Can <br />Sam tuer bucket <br />bleach 4 water for <br />stonng wiping doths <br />Boolh must be on <br />Concrete. Asphalt. <br />Plywood, or a Tarp <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 />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: z\ o. <br />5 Gal Hand wash <br />Wastewater Container <br />^\\A <br />Da <br />Names of responsible persons to be present in booth during all hours of operation: <br />ox- oy qyxotga • <br />Mfr ft’.: mi e*t11 <br />5-20 Gal <br />Hand wash Water <br />—JL <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 priorjo <br />this event x—X <br />Til