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10. <br />11. <br />Oft <br />12. <br />Paper tov.c!s and pump-afr/g soap container. <br />1'3. <br />ConipW&d be 14. <br />Health Pennit <br />PapvHandTcMMls <br />Cu&lflQ Board 1Propane Stove <br />Propane Tank <br />BMcti md WatarRnMWMar <br />Ice Cooler <br />PagaBof 11 TEMP EVENT APP <br />Scanned with CamScanner <br />EHD 16-02 <br />06rtW19 <br />£rt» lea Bapa * Food CodaOian muat ba <br />■tarad dMw o*</*>o graind <br />SGaOtmdwdi <br />WrtaaatwConMnar <br />uaGaL. <br />HandaaahWaar <br />Garbage <br />Can <br />SiniSzerbuclol- <br />atadng wiping dodis <br />1 am providing WM^ngTnraCfequsfg.Tjar/tP woMTwTafiSt^s.'txrt ssparais'rrom Utensil wasn wifriin my <br />booth: <br />SEsmaaiCMt^ <br />Dteh <br />ww <br />We <br />1 am providing the ttSovdng items vvKhtn my tooth for the sanSsn <br /> Three compartment sink. <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 folluwiiiq day. maintain below 41 °F temperature): <br />yi Ice chests Refrigerator <br />r~j RfifrigRraiflri injek i~~i ico hath arvi tuns <br /> Other (specify)__ __________________________________________ <br />"Important** <br />I 1 eaapandWalr <br />I, | FtwEdlrgAtw ~| <br />^Water supply dispenser with warm water at a minimum of 100’F (i.e. 5-20 gallon container with spigot). <br />yfone separate tub (bucket or basin) for the collection of rinse/wastewater. <br />JZ! Three deep tubs (basins B^8 indies minimum), one for soppy water, one for rinsing and one for a bleadi <br />'tokrtion (one tablespoon of bleach per 5aBoft .t&®atert!, <br />XjJDeterqent. bleadi, and wiping dothe (cteanhigtowels). <br />W Tub to store wiping cloths in bleach solution. <br />Names of resoonsible oersons to be present in booth ounno all hours o) ooeration: <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 arlB^operation. Return original to festival coordinator three weeks prior to <br />vy 'MHglfature I ) Titfe Date r" <br />----------------------\ <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, ora Tarp- <br />_____________/