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I am providing the following items within my booth for warewashing:11. <br />O^Three compartment sink. <br />OR i <br />12. lam providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br />'etergent, bleach, wiping cloths (cleaning towels), and a tub to store wiping cloths in bleach solution. <br />13. I am providing the following for adequate hand washing facilities, but separate from utensil wash within my booth: <br />14. <br /> ■ <br />“Important** <br />15.Completed by: <br />re <br />Paper Hnnd Towels <br />dCmtlnfl Board <br />BleachPropana SIovg <br />/Z <br />PfopanoTank <br />Bleach and WalerRfrtso WaterSoap and Water <br />Fire Extfnaufeher <br /> a <br />Ice Cooler <br />slarcd 5 inches oH of ihc ground! <br />TEMP EVENT APPPage 8 of 11EHD 16-02 <br />7/1-1/15 <br />Q'Water supply dispenser with warm water at a minimum of 100T (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 />□ 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 />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 arjEtdopes^tion. Return original to festival coordinator throe weeks prior to <br />this event.-JA \ <br />Slerno w/Chafling <br />Did i <br />□ Refrigerator <br />□ Ice bath and tubs <br />Exira <br />Waler <br />5 Gal Hand wash <br />Wastewater Container <br />Gaibage <br />Can <br />Sanilizer bucket- <br />bteoch & water ter <br />storing wiping clolhs <br />JZ'fce chests <br />□ Refrigerated truck <br />□ Other (specify) <br />0-20 Gal. <br />Hand wash Water <br />i <br />! <br />j <br />Title <br />'at <br />Exira Ice Bags & Pood Conlainers must be <br />stored 6 inchesofi of Ihc ground! i <br />10. lam 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 />| Soap dlcpansar <br />Health Permit d <br />— <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />Names of responsible persons to be present in booth during all hours of operation: