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&MD if <br />14. Completed <br />1-1izalth PArrn if <br />kJ noir,,, EaJ,iL ty <br />Dish <br />I Propane Tank <br />I Extra <br />Water <br /> <br />5 Gal Hand wash <br /> <br />SANAUALJUIN Environmental Health Department <br />C11 I V- <br />.4 is <br />45°F (if food is used the following day, maintain below 41°F temperature): <br />c.hestR <br />/KRefrigerated truck <br />ri no., I ertrznifill <br />fl Refriae.ratry <br />Ice bath and tubs <br />I a roviding the following items within my booth for the sanitary cleaning of food preparation utensil <br />Three compartment sink. <br />OR <br />L] 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 />171 Detergent, bleach, and wiping cloths (cleaning towels). <br />1-1 :oft <br />- <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />0 Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />0 One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />Paper towels and pump-style soap container. <br />Names of re onsi le persons to,lpe present in booth,Jrin all lours oi opera t on: . , <br />MO 6PieR/1 / ry CP0/) 4/1/ —4?:38 <br />**Important** All food vendor booths are subject to inspection. Please make a copy of this application in <br />preparation f this event. A copy of this checklist must be in the booth at all hours of <br />cpreparatt an operat' n ur ori inal to festival coordinator three weeks prior to <br />'62 ffeer41/6/724' Ii/7/-3 <br />/ <br />r I Hand wash Water I <br />32; <br />5-20 Gal <br />Paper Hand Towels <br />S,Rrs di.r.,,,eor <br />(Ice Cooler <br />Cutting Board ISanitizer bucket- <br />storing wiping cloths <br />bleach 8, water for <br />r=1 I F=X r Booth must be on es"rkere.fx. A,*.r,b. <br />h=rriki U Plywood, or a Tarp. <br />stored 6 inches off of the ground! <br />r_r-n;tuAcie <br />Soap and Water Rinse Water <br /> <br />Bleach and Water <br />* <br />Garbage <br />es, es N.— —1 —gr ,14,017 II. "II" • " <br />I I ICILLGI111401 iM114....11141IG I I, VII:1111 MO .7•1&..".1 I S 4.%0•ZI <br />EHD 16-02 06/29/2023 Page 8 of 11 <br />,011.• A, A • g.s,, 5i5I I ..MO VW WI VI .J.114%011 ...111)11GI p.4 <br />TEMP EVENT APP