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r <br /> 10. 1 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 /> Q Ice chests ❑ Refrigerator <br /> [,Refrigerated truck ❑ Ice bath and tubs <br /> ❑ Other(specify) <br /> 11. 1 am providing the following items within my booth for warewashing: <br /> ❑ Three compartment sink. <br /> OR <br /> hree 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 /> 12. 1 am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br /> ❑p€tergent, bleach,wiping cloths(cleaning towels),and a tub to store wiping cloths in bleach solution. <br /> 13. 1 am providing the following for adequate hand washing facilities, but separate from utensil wash within my booth: <br /> Q,Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). A <br /> separate tub (bucket or basin) for the collection of rinse/wastewater. Paper towels and a pump-style soap <br /> container. <br /> 14. Names of responsible erso s to be present in booth during all hours of operation: <br /> .D�t u e c1c,C-t7 <br /> 'Important`* 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 a en . <br /> 15. Completed by: J vS` b eft d i I-,e G l <br /> Signature Title Date <br /> 5-20 Gal. <br /> Health Permit Hand wash Water <br /> Stemo w/Chaffing <br /> Dish <br /> Paper Hand Towels <br /> Soap dispenser <br /> Cutting Board Sanitizer bucket- <br /> bleach&water for <br /> Propane Stove Bleach storing wiping doths <br /> Booth must be on <br /> 7WWater <br /> JBIeach�Hd <br /> 0Concrete,Asphalt, <br /> Z, Plywood,or a Tarp. <br /> Propane Tank <br /> Soap and Water water Garbage <br /> Can <br /> Fire Extinguisher <br /> Extra <br /> Water <br /> Fice Cooler -_ 5 Gal Hand wash <br /> Extra Ice Bags&Food Containers must be wastewater Container <br /> stored 6 inches off of the ground! 1 <br /> EHD 16-02 Page 8 of 11 TEMP EVENT APP <br /> 7/14/15 <br />