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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 />K[Tub to store wiping cloths in bleach solution. <br />12. <br />Completed by: 14. <br />Sj ire <br />Paper Hand Towers <br />JCuib'og Board <br />BleachPropane S(ov& <br />Soap and Water Breach and Water <br />Fire Extinguisher <br />Page 8 of 11 TEMP EVENT APPEHD 16-02 <br />7/28/10 <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 />Paper towels and pump-style soap container. <br />Ice chests <br /> Refrigerated truck <br /> Other (specify) <br />Exira ice Bags & Food Conlalncis musl be <br />stored C Inches off of the ground! <br />StemowfChaffing <br />Dish <br /> Refrigerator <br /> Ice bath and tubs <br />S-20 Gal. <br />Hand wash Waler <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />5 Gal Hand wash <br />Wastcwalcr Conlaioer <br />Extra <br />Water <br />Sanftizcrbucitet- <br />bleachfi water for <br />storing wiping cJolhs <br />J"8Health Permit <br />Or' <br />Title <br />^-/z-zz <br />Date <br />“Important** <br />gMz- <br />13. Names of responsible persons to be present in booth during all hours of operation: <br />Jbig.s , Af y r g_ ________________________________ <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 />AH 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 />Ice Cooler f <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 />^arr^providing the following for adequate hand washing facilities, but separate from utensil wash v/thin my <br />Garbage <br />Can <br />Rinso Water <br />I Propane Tank <br />Soap dispenser