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10. <br />I am providing the following items within my booth for warewashing:11. <br />OR <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensils:12. <br />O Detergent, bleach, wiping cloths (cleaning towels), and a tub to store wiping cloths in bleach solution. <br />14. <br />Completed by: 15. <br />Paper Hand Towels <br />iSoap dispenser <br />Cutting Board <br />BleachPropane Stove <br />Propana Tank <br />Bleach and Waler <br />Fire Extinguisherfl <br />Ice Cooler <br />TEMP EVENT APRPageB of 11 <br />Soap and Waler <br />EHD 16-02 <br />7/14/15 <br />□ Ice chests <br />□ Refrigerated truck <br />Esther (specify) <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 41 °F temperature): <br />Exira <br />Water <br />5 Gal Hand wash <br />Wastewater Container <br />Garbage <br />Can <br />Sanitizer bucket­ <br />bleach & water for <br />storing wiping cloths <br />Booth must be on <br />Concrete, Asphalt, <br /> Plywood, or a Tarp- <br />5-20 Gal. <br />Hand wash Water <br />Extra Ice Bags & Food Containers must be stored 6 inches off of the ground! <br />Sterno w/Chaffing <br />Dish <br />□ Refrigerator <br />□ Ice bath and tubs <br />..siW <br />ZXFl— <br />Title Date <br />UFL i.-. -I <br />sons ito be on <br />dpt (Aa-iO <br />13. lam providing the following for adequate hand washing facilities, but separate from utensil wash within my booth: <br />jl^T^Vater supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). A <br />separate tub (bucket or basin) for the collection of rinse/wastewater. Paper towels and a pump-style soap <br />container. <br />wl:X- .‘Ar, 7?*^ <br />Nam(Ss)of responsible persqnsjto be present in booth during all hours of operation: <br />**lmpbrtant** <br />Rinse Water <br />■ _ <br />AH rood 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 />this event. <br />□ Three compartment sink. <br />E'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 />Health Permit p <br />^^S^nature