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10. <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensils:11. <br /> Three compartment sink. <br />OR <br />Detergent, bleach, and wiping cloths (cleaning towels). <br />j^J'Tub to store wiping cloths in bleach solution. <br />12. <br />C-^Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />0 Paper towels and pump-style soap container. <br />13. <br />14.Completed by: <br />TitleSignature <br />Paper Hand Towels <br />Soap dispenser <br />Cutting Board <br />BleachPropane Stove <br />Rinse Water Bleach and Water <br />Fire Extinguisher <br />Page 8 of 11 TEMP EVENT APP <br />_z <br />Soap and Water <br />EHD 16-02 <br />08/01/16 <br />O'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 />O' Ice chests <br /> Refrigerated truck <br /> Other (specify) <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <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 />Extra Ice Bags & Food Containers must be <br />stored 6 inches off of the ground! <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 />Sterno w/Chaffing <br />Dish <br />5 Gal Hand wash <br />Wastewater Container <br />Garbage <br />Can <br />Sanitizer bucket­ <br />bleach & water for <br />storing wiping cloths <br /> Booth must be on <br />Concrete, Asphalt, <br />Plywood, ora Tarp. <br /> Refrigerator <br />0 Ice bath and tubs <br />5-20 Gal. <br />Hand wash Water <br />( Extra \ <br />/ Water <br />Names of responsible p^rso <br />> <br />Propane Tank <br />ions to be present in booth during all hours of operation: <br />>0-^-0 <br />| Health Permit <br />**lmportant** <br />(3 <br />Ice Cooler <br />W 1 In <br />Date