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9. <br />□ Other (specify) <br />10.I am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br />^^Three compartment sink. <br />OR <br />11. <br />J^lWater supply dispenser with warm water ata 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 />12. <br />13.Completed by: <br />Signature <br />Health Permit <br />Paper Hand Towels <br />Culling Board <br />Propane Slovo <br />I <br />Propane Tank <br />Bleach and Water <br />Flro Extinguisher <br />Ice Cooler <br />Page 8 of 11 TEMP EVENT APP <br />-■ <br />Title <br />EHD 16-02 <br />08/01/10 <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />REC-001-B <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 />"^-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 />S^ljce chests <br />□ Refrigerated truck <br />Sterno w/Chafflng <br />Dish <br />Booth must be on <br />Concroto, Asphalt, <br />Plywood, or a Tarp. <br />5-20 Gal. <br />Hand wash Water <br />Date <br />**lmportant** 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 Avefy, <br />I <br />Soap and Water <br />7 <br />Rinso Water <br />Detergent, bleach, and wiping cloths (cleaning towels). <br />'^],Tub to store wiping cloths in bleach solution. <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 />^xPaper towels and pump-style soap container. <br />Names of responsible persons t^> be present in booth during all hours of operation: <br />Soap dlsponser ----------- \ <br />Bleach L <br />Exira Ice Bags & Food Containers must be . j <br />stored 6 Inches oil ol the groundl 1