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10. <br />I am providing the following items within my booth for warewashing:11. <br />□ Three compartment sink. <br />OR <br />12. lam 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 />13. lam providing the following for adequate hand washing facilities, but separate from utensil wash within my booth; <br />Names of responsible persons to bo present in booth during all hours of operation:14. <br />’"'Important** <br />15.Completed by: <br />Signature <br />Health Permit <br />Paper Hand Towofc <br />So*?> COwensw <br />CutHnq Board <br />Pro po no Stow <br />Soap and Wsw <br />TEMP EVENT APPPago 0 of 11 <br />i n mu <br />ii <br />I <br />EHD 10-02 <br />[^Ice chests <br />□ Refrigerated truck <br />□ Other (specify) <br />Stamo w/Oiafflno <br />Dim <br />□ Refrigerator <br />[3. Ice bath and tubs <br />6 GaJ Hand waiti <br />WetowatwContalnar <br />Garbage <br />Can <br /> Booth must be on <br />Concreto, Asphalt <br />Plywood, or a Tarp. <br />Sanllfcar buakrt- <br />bloattiilwwtof <br />itodng wtplflfl doth* <br />[>lnj <br />Walar <br />8-20 Gal, <br />Hand v»ah Water <br />Rlnae Water Dlaadi and Water <br />a <br />IMm loo teas & Food ContntnOfs mutt to ■ <br />Hondo inctototroftnogioundt ■ <br />/ "" Z <br />Ice Cooler <br />IZ <br />Title Date <br />^Water supply dispenser with warm water at a minimum of 100°F (l.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^fyle soap <br />container. <br />Propane Tank <br />I am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br />45°F (if food is used the following day, maintain below 41 °F temperature): <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 />Al! 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 thrco_weekg prior to <br />this event , /i <br />Fhw ExSncul»h«r |