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» <br />I am providing the following items within my booth for warewashing:11. <br />OR <br />12. <br />13. <br />14. <br />Completed by:15. <br />Health Permit p <br />Paper Hand Tone's <br />Soap dispenser <br />Culling Board <br />BleachPropane Stove <br />n <br />Bleach and WalerSoap and Water <br />Piro Extinguishere <br />Ice Cooler <br />TEMP EVENT APPPage 8 of 11EHD 16-02 <br />7/14/15 <br />tzxtia Ico Rags a Food Containers must bo <br />stored 6 Inches off of (ho ground! <br />Sterno w/Chaffing <br />Dish <br />Refrigerator <br />□ Ice bath and tubs <br />Garbage <br />Can <br />Sanitizer bucket­ <br />bleach & water for <br />storing wiping cloths <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />Ice chests <br />Refrigerated truck <br />□ Other (specify) <br />5 Gal Hand wash <br />Wastewater Container <br />5-20 Gal. <br />Hand wash Water <br />title <br />' Extra \ <br />Water <br />bate <br />Propane Tank <br />\ i <br />^Important** <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my booth: <br />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. <br />.:T7 _ <br />Rinso Water <br />10. 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 />Names of responsible persons to be 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 checklist must be in the booth at all hours of <br />preparation and operatipn. Return original to festival coord.nator three weeks pripMo <br />this event. <br />Signature <br />Three compartment sink. <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 />I am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br />Detergent, bleach, wiping cloths (cleaning towels), and a tub to store wiping cloths in bleach solution.