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10. <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensils:11. <br />OR <br />□ Detergent, bleach, and wiping cloths (cleaning towels). <br />□ Test strips to measure sanitation levels for bleach solution measuring 10Oppm. <br />O Tub to store wiping cloths in bleach solution measuring lOOppm. <br />12. <br />□ One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />O Paper towels and pump-style soap container. <br />13. <br />"Important** <br />Completed by: 14. <br />Sigrtgtto <br />Health Permit <br /> Paper Hand Towaia <br />Soap d*spenser <br />Cutting Board <br />Propane Stove <br />a <br />Rinaa WaterSoap and Water <br />Fire ExtinguisherQ <br />Ice Cooler <br />TEMP EVENT APPPage 8 of 11 <br />■DateTitle <br />EHD 16-02 <br />11/4/14 <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 4rF temperature): <br />Extn Ic9 Begs A Food Containers must bo <br />stand 6 Inches off of the ground! <br />Stemo w/Chaffing <br />Dish <br />5 Gal Hand wash <br />Wastewater Container <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 />IS^efrigerator <br />□ Ice bath and tubs <br />5-20 Gal. <br />Hand wash Water <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />^ZTWater supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />3 <br />Names, of responsible persons to be present in booth during all hours of operation: <br />g _______________________________________________________ _ <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 />Propane Tank <br />Garbage <br />Can <br />I Bleach <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 />Extra <br />Water