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10. <br />OR <br />12. <br />13. <br />I <br />"Important** <br />14.Completed by; ! <br />Signature Trtte Date <br />! <br />Health Permit <br />Paper Hand Towto <br />Cuffing Board <br />Propane Stovi <br />s <br />Soap and Wrtr Rinse Water BlMcti and Water <br />I Are ExtteflUahar I <br />Ice Cooler <br />PageSof 11 TSuP EVENT APP <br />EHD 16-02 <br />08/01/16 <br />Stemow/Cheffing <br />Dl»h <br />□ Refrigerator <br />□ ice bath and tubs <br />5 Gai Hund wash <br />Wastewater Corrtatew <br />0JWater supply dispenser with warm water at a minimum of 100"F (i.e. 5-20 gallon container with spigot). <br />□ One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />□ Paper towels and purnp-styte soap container. <br />/w Fotxf Corttahora must ba <br />•biwfB^hesQfQftingrDumi! <br />SdnJttear bucket- <br />bteMh&weterfor <br />staring wtetotfi dteha <br />11. lam providing the following items within my booth forthe sanitary cleaning of food preparation utensils: <br />□ Three compartment sink. <br />_—» <br /> Booth must be on <br />Conprete, Asphalt, <br />Plywood, or a Tarp. <br />□ Three deep tabs (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 />□ Tub to store wiping cloths in bleach solution. <br />Garbage <br />Can <br /> <br />I Pwpw* Tank <br />1 >Ble fo5®vlri® 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 />O Ice chests <br />O Refrigerated truck <br />□ Other (specify) <br />5J0 <M, <br />Hand wmh Water <br />present in booth during all hours of operation: <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 checkBst must be in the booth at all hours of <br />preparation and operation. Return original to festival coordinator three weeks prior to <br />this ovntr <br />I Soap dispenser <br />(^providing the following for adequate hand washing facilities, but separate from utensil wash within my