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10. <br />11. <br />OR <br /> Detergent, bleach, and wiping cloths (cleaning towels). <br /> Tub to store wiping cloths in bleach solution. <br />12. <br />13. <br />“Important** <br />14.Completed by: <br />Health Permit <br />Paper Hand Jewels <br />Cut ling Board <br />Propane Stova Bleach <br />a <br />Bleach and W&tec <br />Page 8 of 11 TEMP EVENT APP <br /> <br />EHD 16-02 <br />7/28/W <br /> Ice chests <br /> Refrigerated truck <br /> Other (specify) <br />StemovrfCbaffing <br />Dish <br /> Refrigerator <br /> Ice bath and tubs <br />6 Gal Hand wash <br />Wasfcwalw Container <br />5-20 Gal <br />Hand wash Water <br />Garbage <br />Can <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />Extra <br />Waler <br />Sanrlizerbodtel- <br />Neach& water (or <br />storing wiping doihs <br />DateTitle <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br /> Three compartment sink. <br />l3sThree 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 />[ HreExiInfflisher <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 4rF temperature): <br />I <br />Ice Cooler | <br />[ Prepare Tai* <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 checklist must be in the booth at all hours of <br />preparation and operation. Return original to festival coordinator three weeks prior to <br />ttus event. <br /> <br />X Signature <br />Soap tfspenser I <br />booth13^'09 th8 fo,,0Win9 for adequate hand wash'ng facilities, but separate from utensil wash within my <br />(S^Water supply dispenser with warm water at a minimum of 10O’F (i.e. 5-20 gallon container with spigot). <br />^LOne separate tub (bucket or basin) for the collection of rinse/wastewater. <br />St'Paper towels and pump-style soap container. <br />Napes of responsible persons to be present in booth during all hours of operation: <br />J y o <br />I Exira ice Bags S, Food Conrainefsmjslbe I <br />I stored G Inches otfof the ground! <br />Soap and Water <br />I <br />Rinse Water