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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 />[x] Detergent, bleach, and wiping cloths (cleaning towels). <br />[x] Tub to store wiping cloths in bleach solution. <br />12. <br />0 Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />Q One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />Q Paper towels and pump-style soap container. <br />13. <br />important** <br />Completed by: 14. <br />Health Permit <br />1 Paper Hand Towels <br />Soap dispenser <br />Cuttinq Board <br />BleachPropane Stove <br /> <br />Soap and Water Bleach and Water <br />Frro ExlinQUtthor <br />Ice Cooler <br />Page 8 of 11 TEMP EVENT APP <br />Exira <br />Water <br />EHD 15-02 <br />08/01/16 <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 />0 Ice chests <br />□ Refrigerated truck <br />□ Other (specify) <br />Names of responsible persons to be present in booth during all hours of operation: <br />Rahela Qari <br />Extra lea Bagx & Food Containan must ba <br />tiond 6 inches off of ths ground! <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 />0 Refrigerator <br />□ Ice bath and tubs <br />Garbage <br />Can <br />0 Three deep tubs (basins 6-B 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 />Sfemo w/Chaffing <br />Dish <br />5 Gai Hand wash <br />Wastewater Container <br />Sanitizer bucket- <br />bioach & water for <br />storing wiping dotfis <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />S-20 GaL <br />Hand washWater <br />Manager <br />Title <br />7/12/17 <br />Date <br />Propane Tank <br />Signature <br />Rinse Water <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp.