Laserfiche WebLink
10. <br />11. <br />OR <br />12.I am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br />etergent, bleach, wiping cloths (cleaning towels), and a tub to store wiping cloths in bleach solution. <br />13. <br />14. <br />**lm portant** <br />15.Completed by: <br />I <br />Paper Hand Towels <br />Soap dispenser <br />Cutting Board <br />BleachPropane Stove <br />Propane Tank <br />Bleach and Water <br />Fire Extinguisher <br />Ice Cooler <br />Page 8 of 11 TEMP EVENT APPEHD 16-02 <br />7/14/15 <br />□ Ice chests <br />O Refrigerated truck <br />□ Other (specify) <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 />5 Gal Hand wash <br />Wastewater Container <br />Garbage <br />Can <br />Sanitizer bucket­ <br />bleach & water for <br />storing wiping doths <br /> Booth must be on <br />Concrete, Asphalt, <br />Plywood, ora Tarp. <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 />5-20 Gal. <br />Hand wash Water <br />Stemo w/Chaffing <br />Dish <br />^hefrigerator <br />□ Ice bath and tubs <br />Extra <br />Water <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my booth: <br />JS3 Water 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-style soap <br />container. <br />Title <br />Rinse WaterSoap and Water <br />I am providing the following items within my booth for warewashing: <br />^5'three compartment sink. <br />Date <br />I Health Permit <br />Narpes of responsible persons to be present in booth during all hours of operation. • <br />£ r F v cD-vi s. <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 apd^operation. Return original to festival coordinator three weeks prior to <br />this event. <br />' Signature <br />Extra Ice Bags & Food Containers must be ■ <br />stored 6 Inches off of the ground! j-.j