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. . w. <br />11, <br />OR <br />12.1 ai <br />solution. <br />13. <br />14. <br />15.Completed by: <br />Signature <br />Sosp dispenser <br />CuWng Board <br />Propane Stove <br />Bteacr and Wat&r <br />Fire ExUnguisMef <br />i Ice Cooler <br />Page e ef 11 <br />TEMP EVENT APP <br />I <br />/ <br />EHO 16-02 <br />7/W1S <br />Garbage <br />Can <br />Sanilirar budcet- <br />bleach & for <br />storing wiping dotM <br />Slesix) vv/Chaffifjg <br />Dish <br /> Refrigerator <br /> Ice bath and tubs <br />copy of this application in <br />...- ------1 at al) hours of <br />I am providing the following items within my booth for warewashing' <br /> Three compartment sink <br />5 Ga Kit no wash <br />Wasttrw^fer OooMr&r <br />WO Oal. <br />Hi;KJ w-asr Writer <br />5,'dra <br />Water <br />Jce 4 FoM CQnt9Tierz, -must f>? <br />stonxi 6'Irenes or of the Qrouna- <br />-17- (h <br />DateTitle <br />Bootti must be on <br />ConcretB, Asphalt. <br />Plywood, or a Tarp.7 <br />Rinse Water <br />1 ayproviding the following items within my booth for the sanitary cleaning of food preparation utensils: <br />ES/Detergent, bleach, wiping cloths (cleaning towels), and a tub to store wiping cloths in bleach <br />Propffn<? Tank ) <br />I yyroviding the following for adequate hand washing facilities, but separate from utensil wash within my booth: <br /> Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with soiaotl A <br />XnSner. b co,lection of ^seAvastewater. Paper towels and a pump-stvte soap <br />Important** <br />7 J—I ; <br />HfThree 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). y <br />' ■the COlCi ternperature contrc>l fpr the cold holding of potentially hazardous foods below <br />45 F (if food is used the following day, maintain below 417 temperature): <br />M Ice chests <br /> Refrigerated truck <br /> Other (specify) <br />I Health Permit <br />preparation for this event. <br />preparation anpKJperation. <br />this event. // <br />Names py^spon^bte personsjp be in during all hours of operation <br />AlHood vendor booths are subject’to inspection. Please'make a c_r, J, <br />’ A copy of this checklist must be m the "booth <br />21 <br />6os» ana Walsr <br />Pjpe' H«nd Tewls