Laserfiche WebLink
10. <br /> <br /> <br />11. <br />OR <br />12. <br />13. <br />14.Completed by: <br />Signature Date <br />Health Permit <br />Paper HandTwefs <br />CuWog Board <br />Bleach <br />Soap and Water Rinse Water Bleach and Water <br />J <br />Page 8 or 11 TEMP EVENT APP <br />EHD 16-02 <br />7/28/10 <br />Extra /os Bags & Foot Containers most be <br />stored c tncbes off ortho groom’ <br /> Refrigerator <br /> ice bath and tubs <br />S-20 Gat <br />Hand wash Waler <br />Sanitizer biKKet- <br />Heachfi waler (or <br />storing wiping do'Jis <br /> Boolh must be on <br />Concrete, Asphalt, <br /> Plywood, or a Tarp. <br />Slemow/Chalfing <br />t&h <br />Extra <br />Waler <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br /> Three compartment sink. <br />0 Water supply dispenser with warm water at a minimum of 100T (i.e. 5-20 gallon container with spigot). <br /> One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />O Paper towels and pump-style soap container <br />Title <br />‘•Important** <br />boaoTh:Pr°VidinS thS fOnOW1R9 f°r adeqUate hand WaShin3 faCl,iHes> but separate from utensil wash within my <br />SMp’' “”e ** ”8"’9 and °"e for ‘bteach <br />0-Detergent, bleach, and wiping cloths (cleaning towels). <br /> Tub to store wiping cloths in bleach solution. <br />—— -- - <br />Garbage <br />Can <br />1 a~.pr°Y’din9the fo!jTnx9,?oId temPera!ure 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): V 6 °W <br />01ce chests <br /> Refrigerated truck <br /> Other (specify) <br />5 Gal Hand wash <br />Wastewater Container <br />B/ If <br />----------------Ice Cooler | <br />[ Propane Tank <br />Fire ExtingiBsher <br />I Propane Stova <br />thfsevent1 Operatl°n' Return original to festival coordinator three weeks prior to <br />| Soap dispenser | <br />Names of responsible persons to be present in booth during all hours of operation: <br />