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'id.ly hazardous foods below <br />11. <br /> Three compartment sink. <br />OR <br />12. <br />13. <br />■** <br />14.Completed by: <br />Date <br />2 <br />1 <br />Paper Hand Towels <br />Soap dispenser <br />Propane Stove Bleach <br />fCo-V.I <br />Propane Tank <br />Soap and Waler Eieaoh and Water <br />Fire Extinguisher <br />Page 8 of 11 TEMP EVENT APP <br />Rinse Water <br />EHD 16-02 <br />11/4/14 <br />5 Gai Hand wash <br />Wastewater Container <br />Garbage <br />Can <br />Stemo w/Chaffing <br />Dish <br /> Refrigerator <br />tefjee bath and tubs <br />5-20 Gal <br />Hand wash Water <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />I Extra <br />I Water <br />Health Permit » <br />Water 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 />Paper towels and pump-style soap container. <br />________/I <br />Ice Cooler ! i <br />__________ <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br />Extra Ice Bags & Food Containers must be <br />stored 6 inches off of the ground! <br />■^uhree 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 />^Detergent, bleach, and 'wiping cloths (cleaning towels). <br />Test strips to measure sanitation levels for bleach solution measuring 100ppm. <br />j^Tub to store wiping cloths in bleach solution measuring lOOppm. <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within mv <br />booth: <br />3 Signature <br />Qi-T hqf )sun <br />Title <br />Names of responsible persons to be present in booth during all hours of operation: <br />Important** 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 opsratjoh. Return original to festival coordinator three weeks prior to <br />thisxeVent7^>< h <br />I am providing the following cc mperature control for the cold holding of potf <br />45T (if food is used the following day, maintain below 41 °F temperature): <br />^.Ice chests <br /> Refrigerated truck <br /> Other (specify) <br />Sanitizer bucket­ <br />bleach & water for <br />f storing wiping cloths <br />Cutting Board