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10. <br />11. <br />12. <br /> Detergent, bleach, wiping cloths (cleaning towels), and a tub to store wiping cloths in bleach solution. <br />13. <br />14. <br />15. <br />Title <br />Health Permit <br />]Paper Hand Tp^eis <br />Soap dispenser <br />Cutting Board <br />Propane Stovt,Bleach <br />T <br />Propane Tank <br />Rinse Water Bleach and Water <br />Fire Extinguisher <br />Ice Cooler <br />Soap and Water <br />Extra lee Bags & Food Containers must be <br />stored 6 inches off of the ground1 <br />Hj Refrigerator <br /> Ice bath and tubs <br />5 Gal Hand wash <br />Wastewater Container <br />Garbage <br />Can <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />0 Ice chests <br /> Refrigerated truck <br />O Other (specify) <br />Stemo w/Chsffirig <br />Dish <br />Extra <br />Water <br />5-20 Gal <br />Hand wash Water <br />Sanitiser bueket- <br />bleach & water for <br />storing wiping cloths <br />Date <br />nt in booth during all hours of operation: <br />\ X Yy\ A.____________ <br />Completed by: __or <br />am providing the following items within my booth for warewashing: <br />L ...I Three compartment sink. <br />Signafyre <br />! am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <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 event. <br />I 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 />“Important"' <br />I am providing the following co>d temperature control for the cold holding of potentially hazardous foods belov; <br />45°F (if food is used the following day, maintain below 41 °F temperature): <br />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 toweis and a pump-style soap <br />container. <br />Names of responsible persons to be present. <br /> o'