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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 />Q'Three compartment sink. <br />OR <br />□ Detergent, bleach, and wiping cloths (cleaning towels). <br />□ Tub to store wiping cloths in bleach solution. <br />12. <br />-0rtA/ater 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 />D-P^per towels and pump-style soap container. <br />13. <br />‘‘Important** <br />Completed by:14. <br />Health Permit <br />I <br />Paper Hand Towels <br />Soup dispenser <br />Cutting Board <br />BleachPropane Stovo <br />DI <br />Bleach and Water <br />ire <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 for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <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 />□ Ice chests <br />^ Refrigerated truck <br />□ Other (specify) <br />Extra Ice Bags & Food Containers must be <br />stored 6 inches otto! the ground! <br />□ Refrigerator <br />□ Ice bath and tubs <br />5 Gal Hand wash <br />Wastewater Container <br />Garbage <br />Can <br />Sanitizer bucket- <br />bieach & water (or <br />staring wiping doths <br />Sterno w/Chaffing <br />Dish <br />5-20 Gal. <br />Hand wash Water <br />Booth must be on <br />Concrete, Asphalt. <br />Plywood, or a Tarp. <br />Ice Cooler | <br />MxzA/ <br />Title <br />Propane Tank _________>1 <br />Soap and Water <br />/ <br />Rinse Water <br />U I <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. I <br />— <br />Narqes pf responsible persons to be present in booth during all hours of operation: <br />T----1 |M <br />E.linsuialwr <br />Extra <br />Waler