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1 <br /> 10. 1 am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br /> 45* (if food is used the following day,maintain below 41OF temperature): s <br /> El Ice chests ❑ Refrigerator <br /> ❑Refrigerated truck ❑ Ice bath and tubs <br /> ❑Other(specify) -____ <br /> i <br /> 11. 1 am providing the following items within my booth for warewashing: <br /> ❑Three compartment sink. <br /> OR <br /> ® 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 /> 12. 1 am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br /> 9 <br /> ® Detergent, bleach,wiping cloths(cleaning towels), and a tub to store wiping cloths in bleach solution. <br /> t <br /> 13. tam 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 (Le. 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 soar # <br /> container. - <br /> i <br /> 14. Names of responsible persons to be present in booth during all hours of operation: <br /> Dane Thibodeaux <br /> **Important** 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 t <br /> preparation and operation. Return original to festival coordinator three weeks prior-to <br /> this event. <br /> a <br /> 15. Completed by: °0`A7"�"1"� Owner 4/16/2016 <br /> Signature Title Date <br /> 1,20 Gal. i <br /> Health Permit Hand washWalor <br /> Slerno w/Cheffing <br /> Dish Paper Hand Towels a <br /> • Soap dispenser - <br /> CutltngBoard Sanllizar bucket- a <br /> bleach&water for <br /> Propane Stove <br /> Bleach storing wiping cloths <br /> Booth must be on l <br /> Concrete,Asphalt, <br /> Plywood,or a Tarp.------------- <br /> Soap and Water Rinse Water Bleach and Water Garbage ' <br /> can <br /> Firo Exllnnulsher. qq <br /> Extra 1 <br /> Water d <br /> .. -��-•N�!i 1. �::_ _ _ - -::'i� 6 Gal Hand tvaeh r <br /> Ice Cooler :: ;:,;:,,;r,:<.:;::.,;;;::,;:.;; ., <br /> ExUa Ice Baps d Foad Conlalners must be , Waslewafer Contalnor i <br /> --------------- stored 6 Inches o#otthegroundl <br /> 3 <br /> EHD 16.02 Page fl of t i TEMP EVENT APP l <br /> 7/14/15 <br />