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r <br />10. <br />11.I am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br />OR <br />□ Detergent, bleach, and wiping cloths {cleaning towels). <br />□ Tub to store wiping cloths in bleach solution. <br />12. <br />□ Water supply dispenser with warm water at a minimum of 100”F (i.e. 5-20 gallon container with spigot) <br />O One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />□ Paper towels and pump-style soap container. <br />13.Names of responsible persons to be present in booth during all hours of operation: <br />“Important** <br />ompfeted by: <br />Signature Title Date <br />Health Permit t <br />Papof Hand Tc.vels <br />Cutting Board <br />BleachPropane Stove <br />X h <br />Rinse Water Bleach and Watern. <br />Fire ExtingtAsher <br />Page 8 of TEMPt£VENT APP <br />■ •'_________ <br />- ■■.er-. ■■ . ' :■ :■ t ; <br />EHD 1602 <br />7/2BriO <br />Q'ftefrigerator <br />□ Ice bath and tubs <br />5 Gal Hand wash <br />Wastewater Container <br />5-20 Gal. <br />Hand wash Water <br />Sanftizer txtcfcel- <br />WeachA waler lor <br />storing wiping cfolhs <br />Booth must be on <br />Concrete. Asphalt, <br />Piywood. or a Tarp. <br />St emo w/Chalfiog <br />Dish <br />I Soap dispenser <br />Bz- <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 beiow41°F temperature): <br />Q^ce chests <br />□ Refrigerated truck <br />□ Other (specify) <br />□ Three compartment sink. <br />•H^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 />--------------------------------------------------------\. v V'V.V'^L V<-V/O <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 Sooth at all hours of . <br />preparation and operation. Return originaS to festival coordinator three weeks prior to <br />this event. <br />Ice Cooler s'_____J/ <br />^arr^providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />Soap and Water <br />I Exbv ice Begs & Food ContainefS fiwsl be I j <br />| stored 6 inches offofUie grouW <br />| Propane Tank <br />CT Z <br />Garbage <br />Can