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10. <br />11. <br />OR <br />□ Detergent, bleach, and wiping cloths (cleaning towels). <br />□ Tub to store wiping cloths in bleach solution. <br />12.utensil wash within my <br />□ Paper towels and pump-style soap container. <br />13.Names of responsible persons to be present in booth during all hours of operation: <br />Important** <br />14.Completed by: <br />Title <br />1 <br />Papor Hand Towels <br />Soap dlspHnsm <br />Cultinp Board <br />Propano Slovo Bloac>> <br />L <br />Blaach and Wator <br />Firo Extinqulsliora <br />Ice Cooler I <br />Pago fl of 11 TEMP EVENT APPEHD 16-02 <br />08/01/16 <br />Sterno w/Chalfing <br />Dish <br />□ Refrigerator <br />□ Ice bath and tubs <br />Extra <br />Water <br />5 Gal Hand wash <br />Wastewater Container <br />Garbage <br />Can <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 />Ice chests <br />'^Refrigerated truck <br />□ Other (specify) <br />5-20 Gal <br />Hand wash WaterHealth Permit <br />Extra Ice Bogs & Food Conloitiors must bo ? <br />stored 6 mchos olf of the ground! i, <br />^Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />CZ) One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />7 <br />Rinse Water <br />rr' i <br />Soap arid Water <br />5- f&n 9 <br />Date <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 />Signature <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 />I am providing the following for adequate hand washing facilities, but separate from <br />booth: <br />Propane Tank <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 />I am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br />□ Three compartment sink.