Laserfiche WebLink
10. <br />11. <br />OR <br />□ Detergent, bleach, and wiping cloths (cleaning towels). <br />□ Tub to store wiping cloths in bleach solution. <br />12. <br />13. <br />14.Completed by: <br />Signature Title <br />Health Permit <br />Paper Hand Towels <br />Soap dispenoer <br />Cutting Board 1 B loachPropane Stove <br />t u <br />Propane Tank <br />Soap and Water Rinse Water Bleach and Water <br />Fire Extinguisher <br />Ice Cooler <br />COMPLETE BOTH SIDES AND RETURN WITH EXHIBITOR AGREEMENT <br />Extra lea Bogs & Food Containers must be <br />stored 6 Inches off of the ground1 <br />Slomo w/Chofflng <br />Dish <br />Extra <br />Water <br />S Gal Hand wash <br />Wastewater Container <br />5-20 Gol. <br />Hand wash Water <br />Garbage <br />Can <br />Sanitizer bucket­ <br />bleach & water lor <br />storing wiping cloths <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br />EZfThree compartment sink. <br />^^Refrigerator <br />□ Ice bath and tubs <br />A2 <br />[TTWater supply dispenser with warm water at a minimum of 100oF (i.e. 5-20 gallon container with spigot). <br />Efone separate tub (bucket or basin) for the collection of rinse/wastewater. <br />SfPaper towels and pump-style soap container. <br />’‘Important** <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 />□ 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 />□ Ice chests <br />□ Refrigerated truck <br />GTOther (specify) <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />Names of responsible persons to be present in booth during all hours of operation: <br />Qfl/heA JonfiinjS________________ __________________ <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 and operation. Return original to festival coordinator three weeks prior to <br />this event ' ~ ~ ~~ <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, ora Tarp.