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10. <br />11. <br />□ Three compartment sink. <br />OR <br />Q Detagent bleach, and wiping dolls (cleaning towels). <br />□ Tub to store wiping cloths in bleach sokrtron <br />12. <br />□ Water supply dispenser with wann 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 />□ Paper tuweis and pump-style soap container. <br />is to be present in booth during all hours of operation;13. <br />Completed by14 <br />rteaitii Peimit <br />Hood TtaWtaU <br />Pmean* Sacx* <br />if <br />MS <br />Ice Cooler <br />P»0»8ot11 <br />TEMP EvENT AP* <br />: .;a ,;.p Yn <br />StMPMWMv <br />rnEakM* <br />&TMRT <br />EHD 16 02 caroms <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth <br />□ Refrigerator <br />□ Ice bath and tubs <br />S.2O G>1 <br />□ Three deep tubs (basins 6-B inches minimum), one for soapy water, one for rinsing and one for a bleach <br />solution (one tab espoon of bleach per gallon of water). <br />V*wl»>«k» Coruww <br />Sarwjweuate*. <br />no*? <**« <br />1 am providing the following items within my booth for the sanitary cleaning of food preparation utensils' <br />P/K <br />Names of n <br />----- <br />•* Im porta fir" <br />■ <br />L;.? , <br />Title <br />I am providing the following cold temperature control for the cold hoking of potenfally hazardous foods below <br />45<’F (if food is used the following day, maintain below 4VF temperature): <br />C~~--------------------Booth must be on <br />Concrete, Asphalt. <br />Plywood, or a Taip. <br />_____ <br />Garbage <br />Can <br />| Btaih <br />I Piub—Tx* <br />Q3 <br />Date <br />SovOlfanaar J______\ yZ <br />L cu>ma<v« <br />All food vendor booths are subject to inspection. Please make a copy of thjs application in <br />preparation for this event. A copy of this checklist must be in die booth at all hours of <br />preparation and operation. Return original to festival cnordinator thr&a weeks prior to <br />•** * Awo CMtem nm <br />9 MohR Off df iwuRT <br />□ Ice chests <br />□ Refrigerated buck <br />^3 Other (specify)