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10. <br />11.I am providing the foltowing items within my booth for the sanitary cteaning of food preparation utensils: <br />Three compartment sink. <br />OR <br />12. <br />Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br /> One separate tub (bucket or basin) for the collection of rinse/wastewater. <br /> Paper towels and pump-style soap container. <br />13. <br />**lmportant** <br />14. <br />Date <br />Health Permit <br />Paper Hand Toweli <br />Soap dispenser <br />Cutting Board <br />BleachPropane Stove <br />I <br />Bleach and Water <br />Fire Extinguisher <br />TEMP EVENT APPPage 8 of 11EHD 16-02 <br />08/01/16 <br />Stemo w/Chaffing <br />Dish <br />Extra <br />Water <br />5 Gai Hand wash <br />Wastewater Container <br />5-20 Gai. <br />Hand wash Water <br />Garbage <br />Can <br />Sanitizer bucket­ <br />bleach & water lor <br />storing wiping doths <br />Booth must be on <br />Concrete. Asphalt, <br />Plywood, or a Tarp. <br />Title <br />Propane Tank L <br />Soap and Water <br />7 <br />Rinse Waler <br />^arr^providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />Completed by: ' <br />Signature <br /> 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 />H^Detergent, bleach, and wiping cloths (cleaning towels). <br />ErfTub to store wiping cloths in bleach solution. <br />' the fol,owin9 001(1 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 Refrigerator <br /> Refrigerated truck ice bath and tubs <br /> Other (specify) Pl P m (3 <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 eyenfr <br />Names of responsible persons to be present in booth during all hours of operation: <br />_________ <br />Ice Cooler ! .□■■■■■■■■■■■■■■■■ <br />Extra lea Bags A Food Containen must bo | <br />i ■ -v atorwdtftocftM offer ttegroundf 1