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10. <br />11. <br />OR <br />□ Detergent, bleach, and wiping cloths (cleaning towels). <br />□ Tub to store wiping clolhs in bleach solution. <br />12. <br />13. <br />“Important** <br />14.Completed by: <br />Signature Title <br />Papor Hand Towels <br />Cutting Board <br />Propane Stove Bleach <br />1 <br />Bleach and Water <br />Ice Cooler 1 <br />Page 0 of 11 TEMP EVENT APP <br />ta.-.' 1 Tai: <br />EHD 16-02 <br />08/01/16 <br />Sterno w'Chaffing <br />Dish <br />□ Refrigerator <br />□ Ice bath and tubs <br />5 Gal Hand wash <br />Wastewater Container <br />5-20 Gal. <br />Hand wash Waler <br />Garbage <br />Can <br />Sanitizer bucket­ <br />bleach & waler for <br />storing wiping doths <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br />□ Three compartment sink. <br />R < rretr- A • -v ir,W;r ?• <br />Extra /co Bags & Food Conlainors must bo <br />stored 6 inches oil ol tho ground! i, <br />Propane Tank 7 <br />Rinsu WaterI { Soap and Water <br />yhree 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 />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 utensil wash within mv <br />booth: 3 <br />□ Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />^L,One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />^Paper towels and pump-style soap container. <br />Names of responsible persons to be present in booth during all hours of operation: A <br />' azT£r?^din:? -the f0"°^in? 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 />,ce chests <br />^Refrigerated truck <br />□ Other (specify) <br />| Soap dlspansar j <br />Health Permit I-