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I am providing the following Items within my booth for the sanitary cleaning of food preparation utensils:9. <br />OR <br />10. <br />|3l/Vater supply dispenser with warm water at a minimum of 100°F (l.e. 5-20 gallon container with spigot). <br />A4ArD/,S0^—T <br />•♦Important** <br />- 7 //A^Completed by: 14. <br />DateTitle <br />Health Permit <br />Paper Hand Tmrate <br />Soap Mpanwr <br />SaachPropane Skmo <br />Propawa TanK <br />RmaWetarSoap and Wawr Bleach and Waiar <br />HraEafingUihr <br />Paoaaef 11 TEMP EVtNT APP <br />One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />[^Paper towels and pump-stvle soap container. <br />SiemourfChafflOfl <br />DM) <br />Garbage <br />Can <br />Booth must be on <br />Concrete, Asphalt, <br />Ptywood, or a Tarp. <br />EKD1B-02 <br />1W1W <br />Bdrw fca Saga C Food CW)fa*>ar» mutt b» <br />•fond 4 Inches off ol the grou«ff <br />fiGWHdndwaah <br />WaMMtaur Container <br />SMtMrbudtai- <br />Waachtwawfor <br />atartnc wiping dotha <br />Water <br />13. Names of responsible persons to be present In bpoth during all hours of operation: <br />MAHT t <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 checldJst must be In the booth at all hours of <br />preparation and operation. Return original to (OTttvat coordinator three weeks prior to <br />this event Q <br />z signature <br />Ice Cooler <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />□ Three compartment sink. <br />jz^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 />Detergent, bleach, and wiping cloths (cleaning towels). <br />rfTub to store wiping cloths in bleach solution. <br />5-20 Gd <br />KMdwMhWMr