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OR <br />bleach <br />12. <br />13, <br />••Important** <br />Completed by:14. <br />Signature <br />I loalth Permit <br />Papei Hand 1 owels <br />PioiKine Siovfl <br />Propane hkik <br />Rmsc Walt*Soap and Water <br />r ne i xtinquisner <br />Ice Cooler <br />TEMP EVENT APPPage 8 ol 11 <br />I am [ <br />45’F (if food <br />Stwno w/Chaf(lng <br />Dish <br />E xtra <br />Walw <br />5 Gai Hand wash <br />Wastewaier Container <br />Garbage <br />Can <br />Sanitizer Ducket- <br />bleach & water for <br />s’.oting wiping cloths <br />Booth must be on <br />Concrete. Asphalt. <br />Plywood, or a Tarp. <br />5-20 Gal <br />Hand wash Waler <br />□ Ice chests <br />□ Refrigerated truck <br />□ Other (specify)— <br />Title Date <br />Eitra ice 4 f wd ,T1‘Al <br />srorea 6 meftes cJl ot tne ground1 <br />1 am providing the following items within my booth tor the sanitary cleaning of food preparation utensils: <br />Rj Three compartment sink. <br />p^onZ^;^0 °"e ,Or 3 <br />uS Detergent, bleach, and wiping cloths (cleaning towels). <br />£*0 Tub to store wiping cloths in bleach solution. <br />providing u1G f0|i0Wjng CO|d temperature control for the Col <br />-J is used the following day, maintain below 4rp teniperati?9 pot®ntially hazardOus f00ds below <br />|\f Refrigerator <br />□ ice bath and tubs <br />Names of responsible persons to be present in booth during all hours of operation: <br />_______ <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. <br />I arn^providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />S(.n|c. <br />Kj Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot)- <br />Q One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />Paper towels and pump-style soap container. <br />Soap dispense* <br />Cuiung Board