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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 />□ Three compartment sink. <br />OR <br />□ Detergent, bleach, and wiping cloths (cleaning towels) <br />12. <br />Water 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’aper towels and pump-style soap container. <br />13.esponsible persons to be present <br />"Important** <br />Completed byz14. <br />DateSignature <br />Health Permit <br />Pacer Hand Tow-els <br />C^tinQ Board <br />BJeacnPropene <br />Propane Tank <br />Bieacn and v.'aier <br />Pre EMtnouaher <br />TEMP EVENT APPPage 8 of 11EHD 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 />Slcmo wfCbaff.nr; <br />O Refrigerator <br />Ice bath and tubs <br />5 Ga-' Hand wash <br />Cont»nor <br />5-20 Gat <br />Krri wash Water <br />Garbage <br />Can <br />Booth must be on <br />Concrete. Asphalt. <br />Plywood, or a Tarp. <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth. <br />ic9 4 Food CorCarwx not t* <br />skvod 6 MOtM trte <br />Sander buckct- <br />Weflch & watr* for <br />Komg w^ng oocns <br />ISlce chests <br />□ Refrigerated truck <br />□ Other (specify) <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 />^f,Tub to store wiping cloths in bleach solution. <br />Ice Cooler <br />1/ <br />Names of responsible persons to be present in booth during all hours of operation: <br />-rr-r- <br />i 7^ <br />Scap and Water R nse Water <br />Extra <br />Water