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10. <br />If. <br />12. <br />14. <br />15.Completed by: <br />Title <br />Health Permit <br />Peper Hand Towels <br />Soap dispenser <br />Cutting Board 1Propane Stove Bleach <br />r <br />Prooone Tank <br />Rinse Water Bleach and Water <br />Fire Extinguisher <br />Ice Cooler <br />Soap and Water <br />Extra Ico Hags & Food Contoiners must be <br />olored 6 inches off of the ground1 <br />H Refrigerator <br />□ Ice bath and tubs <br />Extra <br />Water <br />5 Gal Hand wash <br />Wastewater Container <br />Garbage <br />Can <br />□ Ice chests <br />Refrigerated truck <br />□ Other (specify) <br />Stemo w/Chaffing <br />Dish <br />5-20 Gal <br />Hand wash Water <br />Sanitiser bucket­ <br />bleach 8 water for <br />storing wiping cloths <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />Signature \~Date <br />** Im porta nt’* <br />Names of responsible persons to be present.in booth during all hours of operation: <br /> Compos ___ <br />am providing the following items within my booth for warewashing: <br />□ Three compartment sink. <br />am providing the following Cviu temperature control for the cold holding ot potentially hazardous foods below <br />45°F (if food is used the following day, maintain below 41 °F temperature): <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 tQ <br />this event. <br />%LI s hree 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 />! 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 />13, I am providing the following for adequate hand washing facilities, but separate from utensil wash within my booth: <br />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.