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10. <br />11.I am providing the foltowing items within my booth for warewashing: <br />□ Three compartment sink. <br />OR <br />12. <br />13. <br />14. <br />15.Completed by: <br />Health Permit <br />Pap* Hand Towwfs <br />Soap draoeoM* <br />Propan* Stove Bleach <br />I <br />Pnx>an* Tank <br />Rose Water BteacTi and Waler <br />Fa* txtinouiihwQ <br />Page 8 of 11 TEMP EVENT APPEHD 16-02 <br />7/14/15 <br />Stamo w/Ch«fl«>g <br />0M1 <br />frrtra <br />Waler <br />Garbage <br />Can <br />Sar *tuv budurt <br />bteach & water for <br />slonnQ wnpng aotha <br />S Ice chests <br />□ Refrigerated truck <br />□ Other (specify) <br />□ Refrigerator <br />□ Ice bath and tubs <br />5 Gal Har'd wash <br />WnMewotw Cotaw <br />5 20 Gal <br />I tend'Mah Water <br />Booth must be on <br />Concrete. Asphalt. <br />Plywood, or a Tarp <br />Ice Cooler <br />____J> <br />Title <br />Q.. > <br />Sign. <br />L <br />Soap and Water <br />•* Important** <br />Extra Ice Rags i Fool Coctamen must be E <br />stored u mcbes otto! the <jnxm< U <br />Names of responsible persons to be present in booth during all hours of operation: <br />T /ZjSTArJ £O(3|r4 4>C>N <br />07, A*). 3-C <br />Date <br />Ail 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 />this event <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 />‘ tbe fo,,owin9 coW 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 />I am providing the following items within my booth for the sanitary cleaning of food preparation utensils. <br />03 Detergent, bleach, wiping cloths (cleaning towels), and a tub to store wiping cloths in bleach solution. <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my booth: <br />S Water 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.