Laserfiche WebLink
10. <br />11.I am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br /> Three compartment sink. <br />OR <br /> Detergent, bleach, and wiping cloths (cleaning towels). <br /> Tub to store wiping cloths in bleach solution. <br />12. <br />0 Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />0 One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />0 Paper towels and pump-style soap container. <br />13. <br />Date <br />14. <br />Title <br />Health Permit <br />Paper Hand Towels <br />BleachPropane Stove <br />Propane Tank <br />■A <br />Bleach and WaterRmse Water <br />Fire Extmquisher <br />v _ I .! <br />Ice Cooler <br />TEMP EVENT APPPage 8 of 11EHD 16-02 <br />08/01/16 <br />0 Ice chests <br />0 Refrigerated truck <br />0 Other (specify) <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 />0 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 for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />Extra Ice Bags & Food Containers must be <br />stored 6 inches off of the ground! <br />Sterno w/Cha(f ng <br />D>sh <br /> Refrigerator <br /> Ice bath and tubs <br />Extra <br />Waler <br />5 Gal Hand wash <br />Wastewater Container <br />Garbage <br />Can <br />Sanitizer bucket­ <br />bleach & waler for <br />Storing wiping cloths <br />Completed by: <br />Signature <br />5-20 Gal <br />Hand wash Water <br />' 1 ' / <br />Soap and Water <br />|Cutting Board <br />I Soap dispenser <br />Names of responsible persons to be present in booth during all hours of operation: <br />MollAhU’rl ^mlfiPhP 7 -------------------------------------------------------------------------------------------------- <br /> <o)irx.hipd /\l .i &o-rc\rT oJ i----------------------------------------------------------------- -------------------------------- <br />“Important** 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 />----------------------Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp.