Laserfiche WebLink
06/02/2016 15:25 FAX <br />■9 <br />10. <br />I am providing the following Items within my booth for warewashing:11. <br />OR <br />12. <br />13.I am <br />14. <br />Important” <br />Completed by; 15.Title <br />Health Permit <br />Pap«r Hand Tow»l« <br />Soap dispense <br />Cutting Board <br />Bleach <br />Propane Slove <br />Propane Tank <br />Bleach and WaterSoap and Water <br />Fire Extlnsutehar <br />Ice Cooler <br />TEMP EVENT APPPage 6 of 11EMD 16-02 <br />7/14/15 <br />□ Ice chests <br />□ Refrigerated truck <br />□ Other (specify) <br />Extra let Begs 4 Food Coolelnort must b» <br />stored 8 Inches off of lha ground! <br />Ml Refrigerator <br />□ Ice bath and tubs <br />Extra <br />Waler <br />6 Gal Hand wash <br />Waatawater Contalnar <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />Sterna w/Chaffing <br />Dl»h <br />5-20 Gal. <br />Hand wash Waler <br />Garbego <br />Can <br />Sanltlxer buckel- <br />biaach 8. water lor <br />atortng wiping clothe <br />141 002 <br />t'. <br />Date <br />Names of responsible persons to be present In booth during all hours of operation: <br /> <br />Rinse Wolor <br />jJ^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 />P 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: <br />Water supply dispenser with warm water at a minimum of 100°F (l.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 />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 />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 tQ festival coordinator three week? prior to <br />this event. /' ‘ . <br /> <br />xj siqfiature