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10. <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensils:11. <br />□ Three compartment sink. <br />OR <br />□ Detergent, bleach, and wiping cloths (cleaning towels). <br />0 Tub to store wiping cloths in bleach solution. <br />12. <br />[2 Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />13. <br />14.Completed by: <br />Date <br />11 <br />h'Paper Hand Towels <br />Cutting Board <br />Propane Stove <br />JJ Iu <br />Bleach and Water <br />a <br />TEMP EVENT APPPage 8 of 11EHD 16-02 <br />Soap and Water Rinse Water <br />Q Ice chests <br />□ Refrigerated truck <br />□ Other (specify) <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 />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 for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />Extra Ice Bags & Food Containers must be <br />stored 6 inches off of the ground! <br />Sterno w/Chaffing <br />Dish <br />□ Refrigerator <br />[3 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 />H One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />Q Paper towels and pump-style soap container. <br />Propane Tank ---------------> <br />. / <br />| Health Permit <br />**lmportant** <br />Fire Extinguisher <br />Names of responsible persons to be present in booth during all hours of operation: <br />jCic ____________ <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 opej&tion. Return original to festival coordinator three weeks prior to <br />this event. / / <br />Ice Cooler | <br />r coywi v <br />1911^ <br />SVpK <br />I I I I II <br />Sign.