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10. <br />11. <br />OR <br />12. <br />utensil wash within my <br />13. <br />C- <br />14.Completed by: <br />Health Permit <br />Paper Hand Tcwefc <br />J3 <br /> <br />Propane Tank <br />Rinse Water <br />Fire Exfingusber <br />Pag© 8 of 11 TEMP EVENT APP <br />Signature <br />EHD -16-02 <br />7/28710 <br />of 100T (i.e. 5-20 gallon container with spigot). <br />>r the collection of rinseAvastewater. <br />H 'Psper towels and pump-style soap container. <br />5 Gal Hand wash <br />Wastewalcr Container <br />5-20 Gal. <br />Hand wash Waler <br />Ice chests Q Refrigerator <br />E] Refrigerated truck Q Ice bath and tubs <br /> Other (specify) /><?<? <br />Er/ra Ice Bags & Food CcotaltKts must be <br />stored Cinches off of the ground’ <br />Sletro v.iChaffing <br />Dish <br />Sarstizcr budtol- <br />bIsach-& water for <br />storing wiping cfofts <br />| CutUog Board | <br />Propane Sieve _ <br />Title“ <br />cl,; ~ <br />Garbage <br />Can <br />1 “-fS P““* <br />-74- <br />Date <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />I Bleach <br />I Soap dispenser <br />7 ------——————— -------- <br />“Important**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 nrinr to <br />this event. ----------------— <br />boofhProVidin9 lhS fo!i0Wing for adec!uate hand washing facilities, but separate from <br />Blflfeter supply dispenser with warm water at a minimum <br />ET6ne separate tub (bucket or basin) foi <br /> _ J. <br />j j Bleach and Water I I I <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br /> Three compartment sink. <br />£™S«)ne ,or“*■one ,or '“"3 M '»4 <br />0'betergent, bleach, and wiping cloths (cleaning towels). <br />EH Tub to store wiping cloths in bleach solution. <br />—- Z <br />ice Cooler g <br />_ IF <br />LZrzzf <br />Soap and Water <br />Extra Wafer