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10. <br /> Detergent, bleach, and wiping cloths (cleaning towels). <br /> Tub to store wiping cloths in bleach solution. <br />12. <br />13. <br />“Important** <br />14.Completed by:. <br />Title <br />Health Permit <br />Paper Hand Towels <br />Soap dispenser <br />BleachPropane Stove <br />r <br />/ || Soapai <br />I Fre ExficptisTier <br />LT' <br />Rinse Water <br />1 I <br />Page 8 of 11 TEMP EVENT APP <br />. nr*. <br />EHD 16-02 <br />08/01/16 <br /> Ice chests <br /> Refrigerated truck <br />O Other (specify) <br />Stemo w/Chaffing <br />Dish <br />S Refrigerator <br /> Ice bath and tubs <br />Extra <br />Water <br />5 Gai Hand wash <br />Wastewater Container <br />5-20 Gai <br />Hand wash Water <br />Sanitizer bucket- <br />bieach i water for <br />storing wiping cloths <br />Ice Cooler <br />Jr® <br />Propane Tank <br />--------- 1 <br />Date <br />£Z L <br />Soap and Water <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within mv <br />booth: <br />Water supply dispenser with warm water at a minimum of lOOT (i.e. 5-20 gallon container with spigot). <br />''W One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />T^Paper towels and pump-style soap container. <br />Ertra /ce Bags & Food Contamers musr be J <br />stand 6 inches off of foe ground* g , <br />1 the fo^n?.J:Old te,nPerature “H™ 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 />booth during all hours of operation: __ <br />I !P-e my ) py >SL J ________ <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 ail 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, ora Tarp. <br />=1L '—■ <br />Garbage <br />Can <br />Names of responsible persons to be present in I <br />11. lam providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br /> Three compartment sink. <br />tS-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).