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O:\OPERATIONS TECHNICAL\FOOD PROGRAM\UNIT 5\Temp Event\handouts\Temporary Event Booth Self Inspection Form 04-08-14.docx
Alameda County Department of Environmental Health
1131 Harbor Bay Parkway, Alameda CA 94502 PH: (510)567-6700, FAX: (510)337-9134 www.acgov.org/aceh
Temporary Event Booth Pre-inspection/Self Inspection Form
Please complete this form before you begin to serve food to the public, and have it available to show the event sponsor or the
Environmental Health Inspector.
Name of the person in charge of the booth: ________________________________________
(There must be someone designated to be in charge of food safety management and present at all times)
Please complete the items below before serving food to the public.Initial below when completed
1. Hand-wash station has been set up and is ready to use:
Container of water with a spigot which can be turned on and off without having to hold
it on.
Bucket to catch the dirty water
Liquid soap in a pump dispenser
Single use paper towels
1.________
2. Utensil wash station is set up and ready to use:
1 Bucket with soapy water to use for washing
1 Bucket with plain water to use for rinsing
1 Bucket with bleach and water to use for sanitizing
Note: ½ Tablespoon of bleach should be used for each gallon of water
2.________
3. Food preparation tasks are delegated so there are three types of workers:
Those who only touch the raw meat, fish or poultry
Those who only touch ready to eat (RTE) foods
Those who only touch the money.
3.________
4. All food preparation is done inside the booth.4.________
5. If there is a bar-b-que, it can be outside of the booth, but all food cooked outside must
then be taken back inside the booth for service to the customer.
5.________
6. You have a thermometer available in the booth to measure food temperatures. 6.________
7. All cold foods are well iced and are below 45 degrees F. 7.________
8. All hot foods are:
Served directly to the customer, OR
Held at or above 135 degrees F.
Discarded at the end of each day.
8.________
9. Health Permit is prominently displayed in public view 9.________
10. Trash containers are available inside the booth. 10.________
11. Self-service condiments are:
In containers with a hinged lid, OR
In squeeze bottles, OR
In individual packets.
11.________
12. All open food is protected from customer spit from coughing, and sneezing. 12.________
O:\OPERATIONS TECHNICAL\FOOD PROGRAM\UNIT 5\Temp Event\handouts\Temporary Event Booth Self Inspection Form 04-08-14.docx
Alameda County Department of Environmental Health
1131 Harbor Bay Parkway, Alameda CA 94502 PH: (510)567-6700, FAX: (510)337-9134 www.acgov.org/aceh
Hand and Utensil Washing Guidelines for Temporary Event
EXAMPLE OF HAND WASHING SET-UP
Trash Bin
Continous Fl o w Spigot Paper
Towels
5 Gallon
Thermal
Container
5 Gallon
Discard Bucket
Soap
WASH HANDS:
Before:
Starting work
Handling Ready to Eat (RTE)
food
After:
Using restroom
Sneezing
Coughing
Touching raw food
Touching face or hair
Eating or drinking
Emptying garbage
Smoking
Any chance of
contamination
EXAMPLE OF UTENSIL WASHING SET-UP
Step #1: Wash
Step #2: Rinse
Step #3: Sanitize
(1/2 tablespoon Bleach for every 1 Gallon of water)
Step 4: Air Dry
Continuous Flow Spigot