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I am providing the followir.^ .old temperature control for the cold holdin:10. <br />I am providing the following items within my booth for warewashing:11. <br /> Three compartment sink. <br />OR <br />12. <br /> Detergent, bleach, wiping cloths (cleaning towels), and a tub to store wiping cloths in bleach solution. <br />providing the following for adequate hand washing facilities, but separate from utensil wash within my booth:13. lam <br />14. <br />Completed by:15. <br />Signature <br />Health Permit <br />Paper Hand Towels <br />Soap dispenser <br />Cutting Board <br />Bleach <br />Propane Stove <br />IPropane Tank <br />Fire Extinguisher <br />Ice Cooler <br />TEMP EVENT APPPage 8 of 11 <br />n <br />EHD 16-02 <br />7/14/15 <br />Extra /ce Bags & Food Containers must be <br />stored 6 inches off of the ground! <br />Stemo w/Chaffing <br />Dish <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 /> 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 />5-20 Gal. <br />Hand wash Water <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br /> Ice chests Refrigerator <br /> Refrigerated truck Ice bath and tubs <br />[^6ther (specify) <br />Title <br />■ ' k potentially hazardous foods below <br />45OF (if food is used the following day, maintain below 41 °F temperature): <br />Soap and Water <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensils. <br />O 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 />Rinse Water <br />fJ*- f <br />Names of responsible persons to be present in booth during all hours of operation: <br />We/ia <br />**lmportarn** 1 All food venoor 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. J