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J hazardous foods below10. <br />11. <br />OR <br />13. <br />14. <br />Completed by:15. <br />Signature <br />Health Permit <br />Paper Hand Towels <br />Soap dispenser <br />Culling Board <br />Bleach <br />Propane Stove <br />Fire Extinguisher <br />Ice Cooler <br />TEMP EVENT APPPage 8 of 11 <br />Soap and Water Rinse Water <br />EHD 16-02 <br />7/14/15 <br />Sterno w/Chaffing <br />Dish <br />Refrigerator <br />Ice bath and tubs <br />Extra <br />Water <br />5 Gal Hand wash <br />Wastewater Container <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 />5-20 Gal. <br />Hand wash Water <br />Title I <br />Propane Tank '1------------ <br />0 <br />Date ' <br />**lmportant** <br />0 Water supply dispenser with warm water at a minimum of 100°F (i <br />separate tub (bucket or nf rinco/u/aQtPwatAr <br />container. <br />I am providing the following cold terr^.rature control for the cold holding of potent. <br />45°F (!f food is used the following day, maintain below 41°F temperature): <br />Extra Ice Bags & Food Containers must be H <br />stored 6 inches off of the ground! ■ <br />Bleach and Water | <br />I am providing the following items within my booth for warewashing: <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 />12. lam providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br />J^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 />-----------'j.e. 5-20 gallon container with spigot). A <br /> basin) for the collection of rinse/wastewater. Paper towels and a pump-style soap <br />Names of responsible persons to be present in booth during all hours of operation: <br /> --------------------- <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 preparation and operation. Return original to festival coordinator three weeks prior to <br />this event.