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10. <br />11. <br />OR <br />12. <br />13. <br />14.Completed by: <br />Health Permit <br />Paper Hand Towels <br />Soap dispenser <br />Cutting Board <br />BleachPropane Stove <br />Rinse Water Bleach and Water <br />TFMP EVENT APPPago 8 of 11 <br />Sanitizer bucket <br />bleach & waler for <br />storing wiping cloths <br />EHD 16 02 <br />OR/m/16 <br />Exira <br />Water <br />5 Gal Hand wash <br />Wastewater Container <br />Fire Extinguisher <br />I <br />5-20 Gal. <br />Hand wash Water <br />Title <br />I <br />Water supply disperjser with warm water at a minimum of 1 GOT (i.e. 5-20 gallon container with spigot). <br />One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />X] Paper towels and pijmp-style soap container. <br />Na^s of responsible (Jorsons to be present in booth during all hours of operation: <br />**lmportant** <br />I Extra Ice B; gs & Food Container}; must be <br />I stored 6 inc m?s off o! the ground' <br />Soap and Water <br /> Booth must be on <br />Concrete, Asphalt. <br />Plywood, ora Tarp. <br /> _________________7 <br />,-r\ ____________________________________________________ <br />All fcjiod 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 />i <br />Signature <br />Propane Tank <br />------------------------1 <br />I am providing the foliovying items within my booth for the sanitary cleaning of food preparation utensils: <br /> Three compartment jsink. <br /> Three deep tubs (biasins 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 /> Detergent, bleach, and wiping cloths (cleaning towels). <br /> Tub to store wiping ploths in bleach solution. <br />Steijno w/Chaffing <br />* Dish <br />providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />Garbage <br />Can <br />Ice Cooler 'V <br />rhhi <br />Date <br />' fhe ^'"9 cold temperature control for the cold holding of potentially hazardous foods below <br />45 I- (if food is used tjhe following day, maintain below 41 F temperature): <br />D Ice chests Q Refrigerator <br /> Refrigerated truck : ice bath and tubs <br /> Other (specify).