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10. <br />11. <br />OR <br />for soapy water, one for rinsing and one for a bleach <br />12. <br />13. <br />my booth: <br />A <br />14. <br />15.Completed by: <br />Signature <br />Health Permit <br />Paper Wand Towels <br />dCutting Board <br />Propane Stove Bleach <br />r <br />Soap and Water Rinse Waler <br />Fire Extlr.fl ulsher <br />Ice Cooler <br />Page 8 of 11 TEMP EVENTAP.0 <br />■ <br />EHD 16-02 <br />7/14/15 <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br />Detergent, bleach, wiping cloths (cleaning towels), and a tub to store wiping cloths in bleach solution. <br />Exira lea'Sags’i FoodConteunars mast bo <br />stored 6 Irichos offofiho ground! <br />St*mo vr/Chaffing <br />Dish <br />5-20 GaJ. <br />Hand wash Water <br />Garbage <br />Can <br />Sanifaer buclcet- <br />bleacn & water for <br />storing wiping ctoths <br />Booth must be on <br />Concrete, Asphalt. <br />Plywood, or a Tarp. <br />5-Gal Hand wash <br />Waslewater Container <br />Owner <br />Title <br />8/29/16 <br />Date <br /> Ice chests Q Refrigerator <br /> Refrigerated truck Q foe bath and fobs <br /> Other (specify) <br />Propane Tank <br />----------------------J <br />Soap rUsoonser j <br />Vhice Truong nSib,e perSOnS 10 be Presentin booth during.all hours of operation: <br />I am providing the following items within my booth for warewashing: <br /> Three compartment sink. <br />txi Three deep tubs (basins 6-8 inches minimum), one <br />solution (one tablespoon of bleach per gallon of water). <br />**lmportant**All food vendor booths are subject to inspection. Please make a copy of this application in <br />preparation for this evpnt 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. ppL - M-M. JX - <br />Bfeach and Waler [ <br />I am providing the following for adequate hand washing facilities, but separate from' utensil wash within <br />' rWaT Water at a min,mum of 1Q0OF 0-e- 5-20 gallon container with spigot) <br />mniXer b b ‘ baS'n) f°r hS collecflori of rtnse/wastewater. Paper towels and a oumo-stvle span