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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 />^J'ub to store wiping cloths in bleach solution. <br />12. <br />WWater supply dispenser with warm water at a minimum of 100’F (i.e. 5-20 gallon container with spigot) <br />□ One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />J^TPaoer towels and pump-style soap container. <br />13.esponsible persons to be present <br />"Important** <br />Completed byz14. <br />DateSignature <br />Health Permit <br />Paper Hard Towels <br />Soap <br />Propane Tank <br />A <br />Bieacn and Water <br />Pre EtcaTOLttf** <br />TEMP EVENT APPPage 8 of 11 <br />3E <br />EHD 16-02 <br />08/01/16 <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 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 />Extv for Bagi 4 Abad Ccrtavw (Twat M <br />ata^d 0 htfiM off prostf <br />□ Refrigerator <br />Ice bath and tubs <br />Fxfa <br />Water <br />5-20 Ga. <br />wash water <br />Booth musi be on <br />Concrete. Asphalt, <br />Ptywood. or a Tarp. <br />£3Jce chests <br />□ Refrigerated truck <br />□ Other (specify) <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />Sttmo wfChaff-Tx; <br />5 Gai Hard wash <br />V<as-*«w«r»r Convjrnef <br />Sanrtw txxkei- <br />btedch £ wattrr <or <br />stor-g ckwn <br />Title <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 />Ice Cooler <br />_________z <br />^12-1^22- <br />Names of responsible persons to be present in booth during all hours of operation: <br />Garbage <br />Can <br />r~/ <br />Scap and Water R nse Wate'