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to. <br />Tl.I*Kt V tons nhn my booth for warewashing: <br />OR <br />1Z.laMR^natogfefctoMng tons within my booth for the sanitary deaning of food preparation utensils: <br />Sfli't 9 < fateadv wjpfog cloths (deaning towels), and a tub to store wiping cloths in bleach solution. <br />Han pHMfog foe folowing for adequate hand washing fadlities, but separate from utensil wash within my booth: <br />14. <br />“Important** <br />15. Completed by: <br />Signature Title <br />Health Permit <br />Paper Hand Toweis <br />Soap dispenser <br />Cutting Boanl <br />BleachPropane Stove <br />Propane Tank <br />Soap and Wetor Rinse Water Bleach and Water <br />Fire ExUnoUahar <br />Ice Cooler <br />Page 8 of 11 TEMP EVENT APPEHD 16-02 <br />7/14/15 <br />StemowiChafring <br />Dish <br />6 Gai Hand wash <br />WMewaterContainar <br />Garbage <br />Can <br />Sanitzerbudcet- <br />Ueach& water for <br />storing wiping doihs <br />Q Refogerator <br />D ice baft and tubs <br /><• <br />^fcectass v <br />Qnrtfa^iite lifaiBfc <br />00*r$toirWl— <br />Water <br />Names of responsible persons to be present in booth during ail hours of operation: <br />Date <br />I am pruMdmg the folowing cold temperature control for the cold holding of potentially hazardous foods below <br />45*F (i food is used the falowfog day, maintain below 41 °F temperature): <br />Whs (teasms 6-8 inches minrnum), one for soapy water, one for rinsing and one for a bleach <br />tonflnwetaHespoon cf bteach per gallon of water). <br />L^^feto siypty dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container, with spigot). A <br />separate tifo (bucket or basin) for the collection of rinse/wastewater. Paper towels and a pump-style soap <br />container. <br />5-20 Gai. <br />HmwuhWMv <br />— <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />Exira fca Bags S Food Contafows must be K <br />stored 6 tochaa otrafthegmuna B <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 evei