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10. <br />11. <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 />Health Permit <br />Paper Hand Towels <br />Soap dispenser <br />Cutting Board <br />Propane Stove Beach <br />a , t) j <br />Rinse Water <br />Fire Extinguisherfl <br />Ice Cooler <br />Page 8 of 11 TEMP EVENT APPEHD 16-02 <br />08/01/16 <br />Extra Ice Bags & Food Containers must be stored 6 inches off of the ground! <br />Stemo w/Chaffing <br />Dish <br />5 Gai Hand wash <br />Wastewater Container <br />5-20 Gal <br />Hand wash Water <br />Sanitizer bucket­ <br />bleach & water for <br />storing wiping cloths <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />Water supply dispenser with warm water at a minimum of lOO’F (i.e. 5-20 gallon container with spigot). <br />□ One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />Isf Paper towels and pump-style soap container. <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br />□ Three compartment sink. <br />□ Refrigerator <br />□ Ice bath and tubs <br />()(^----- <br />TitleSignature <br />Sr/ /J <br />Date <br />rT <br />Soap and Water <br />1 ar2.£r«!?in9 the fo,lowin9 “W 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 />VJ Ice chests <br />□ Refrigerated truck <br />O Other (specify) <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 />l^am^providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />Names of responsible persons,to ba present in boqfh during all hours of operation: <br /> ci n/ cn d i ___________ <br />Propane Tank <br />------------------------J <br />Garbage <br />Can <br />OR <br />X3 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 />Extra <br />’Water