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10. <br />11. <br />bleachOR <br />12. <br />0. One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />Q Paper towels and pump-style soap container. <br />13. <br />‘‘Important** <br />14. <br />Date <br />P-iper HancJTowit <br />Soap dispetrxr <br />Piopant Stove <br />Bteach <br />Propane Tank <br />Rinse Waler <br />i/u.'.’ <br />Fie Extinquisbef <br />Ice Cooler <br />pa(le 8 of 11 <br />TEMP EVENT APP <br />S^»trtaer txjchel- <br />bte.ach & w-.cct foe <br />stneng wiping duths <br />EHD 16412 <br />08/0 VI6 <br />Ice chests <br />□ Refrigerated truck <br />□ Other (specify). <br />□ Refrigerator <br />□ Ice bath and tubs <br />Stcmo vrfCbaftmg <br />Dish <br />5 Gal Hand wash <br />Waslewaje, Cnnt«z», <br />5-20 Gal <br />Hand wash Water <br />Garbage <br />Can <br />^3 <br />\_________ <br />Bleach .-Kl Water | <br />Gretna Board___j <br />Ouj He r <br />Title <br />■■ j <br />Soap and Water <br />Completed by: q\I \V^g-V\ /? 7 ~ V <br />Signature <br />Booth must be on <br />Concrete, Asphalt <br />Ptywood, or a Tarp <br />Three compartment sink. <br />□ Three deep tubs (basins 6-8 inches minimum), one for soapy water, <br />solution (one tablespoon of bleach per gallon of water). <br />£3 Detergent, bleach, and wiping cloths (cleaning towels). <br />□ Tub to store wiping cloths in bleach solution. <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />JZ] Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensils. <br />one for rinsing and one for a <br />Health Permit^ <br />Names of responsible persons to be present in booth during all hours of operation: <br />Gy<jGP. ~J |7? ~ A.<>r-Ack.____C <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 am providing the following cold temperature control forpTrature^ <br />45°F (if food is used the following day, maintain below 41 F temperat ).