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10.ially hazardous foods below <br />11. <br />□ Three compartment sink. <br />OR <br />12. <br />13 <br />14. <br />15.Completed by: Vo r~ <br />Signature <br />Paper Hand Towels <br />Soap dispenser <br />Cutting Board <br />Propane Stove Bleach <br />Propane Tank <br />Bleach and Water <br />Fire Extinguisher <br />Ice Cooler ! . <br />Page 8 of 11 TEMP EVENT APP <br />I am providing the following items within my booth for warewashing.- <br />1 <br />EHD 16-02 <br />7/14/15 <br />Sterno w/Chaffmg <br />Dish <br />Extra <br />Water <br />5 Gal Hand wash <br />Wastewater Container <br />Garbage <br />Can <br />Sanitizer bucket­ <br />bleach & waler for <br />storing wiping cloths <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />5-20 Gal. <br />Hand wash Water <br />Q^ce chests <br />□ Refrigerated truck <br />□ Other (specify) <br />□ Refrigerator <br />L/ZT Ir'o Hpfh onH h ihc <br />✓T I • V4IIV4 <br />Names of responsible persons to be present in booth during all hours of operation: <br />Date <br />/ <br />Rinse Water <br />Health Permit <br />I -- • 'T. --"77 —■ <br />Exfra Ice Bags & Food Containers must be <br />stored 6 inches off of the ground1 <br />All iooq 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 am providing the following d^^perature control for the cold holding c <br />45°F (if food is used the followingday, maintain below 41 °F temperature): <br />(SvevrA" <br />Title <br />** Im porta nt** <br />^fThree 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 />Soap and Water <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br />0 Detergent, bleach, wiping cloths (cleaning towels), and a tub to store wiping cloths in bleach solution. <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my booth: <br />Efwater 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.