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10. <br /> <br /> <br />11. <br />OR <br />12.I am ■oviding the following items within my booth for the sanitary cleaning of food preparation utensils: <br />13. <br />14. <br />15.Completed by: <br />Signature Title Date <br />[ Health Permit |a <br />Paper Hand Towels <br />Soap dispenser <br />Cutting Board <br />Propane Stove Bleach <br />fPropane Tank <br />z Fire Extinguisher <br />Ice Cooler | <br />Page 8 of 11 TEMP EVENT APP <br />I <br />I <br />/ <br />Rinse Water <br />EHD 16-02 <br />7/14/15 <br />jce chests <br />Sj^efrigerated truck <br />^KJyOther (specify) <br />Sterno w/Chaffing <br />Dish <br />5 Gal Hand wash <br />Wastewater Container <br />Garbage <br />Can <br />Sanitizer bucket­ <br />bleach & water for <br />storing wiping cloths <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, ora Tarp. <br />5-20 Gai. <br />Hand wash Water <br />( Extra \ <br />I Water <br />I <br />Soap and Water <br />\________ <br />Bleach and Water <br />I am providing the following items within my booth for warewashing: <br />□ Three compartment sink. <br />® ■ <br />^Important** <br />^-^[Refrigerator <br />□ Ice bath and tubs <br />□ Three 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 />Extra Ice Bags & Food Containers must be <br />stored 6 inches off of the ground! <br />P^QQ^to bepre^^^^^durin^^^ur^f opera^an:srajan: <br />All food vendor booths are subject to inspection. Pl^e 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 />.E^Det^ent, b^ach’ '-iping clotlis^leani^) ^'^15), ^i^ 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 booth: <br />•tefWater supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). A <br />separate tub (bucket or basin) for the collection of rinse/wastewater. Paper towels and a pump-stvle soao <br />container. —----------