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10, <br />11. <br />OR <br />O Detergent, bleach, and wiping cloths (cleaning towels). <br />12. <br />□ One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />13. <br />Completed by:14. <br />Signature <br />| Health Perr^it^ <br />Paper Hand Towels <br />Soap dispenser <br />Cutting Soard <br />Bteacb <br />Propane Stove <br />Profane Tank <br />S&ap Si xt Water <br />Fire E^rnguistw <br />TEMP EVENT AH’Page 8 of 11 <br />_______ I <br />EHD 18-02 <br />Q Paper towels and pump-style soap container. <br />Names of responsible persons to be present in booth during all hours of operation. <br />Extra <br />Waer <br />S Gal Hand wash <br />Wratawatar Corn®?* <br />5-20 Gal, <br />Hand wash Water <br />Booth must be on <br />Concrete, Asphalt. <br />Plywood, or a Tarp. <br />O Ice chests <br />□ Refrigerated buck <br />□ Other (specify) <br />Stemo w/ChafTing <br />Dish <br />Tltle <br />Sanitiz«r buctost. <br />Mead-I & wtrtsr for <br />xtonng wiping sloths <br />Date <br />/ <br />Rrnss W$t«r <br />"Important** <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br />□ Three compartment sink. <br />EfThree 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 />O Tub to store wiping cloths in bleach solution. <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />□ Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />Ice Cooter | <br />^5 <br />Garbage <br />Can <br />All food vendor booths are subject to inspection. Rease 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 ihr^ weeks.prioLto <br />this event <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 />Exfra !c* a mux? ii» I <br />skMdSinchaiof/of^tiSmina ■ <br />□ Refrigerator <br />□ Ice bath and tubs