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i <br /> 10. I am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br /> 45eF(if food is used the following day,maintain below 41°F temperature): <br /> ❑ Ice chests [ Refrigerator f <br /> ❑ Refrigerated truck ❑Ice bath and tubs <br /> ❑Other(specify) <br /> 11. 1 am providing the following Items within my booth for warewashing: <br /> ❑x Three compartment sink. <br /> OIL <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 /> 6 <br /> 12, 1 am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br /> S <br /> Detergent, bleach,wiping cloths(cleaning towels),and a tub to store wiping cloths in bleach solution. <br /> 13, lam 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 towels and a pump-style soap <br /> container. <br /> 114. Names of responsible persons to be present in booth during all hours of operation: 91 <br /> Mony Vangsoulatda <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 <br /> preparation and operation. Return original to festival coordinator three weeks prior to <br /> this event, t s <br /> i <br /> 15. Completed by: LCr 2 owner/operator 4/14116 <br /> � gt aturQ Title Date <br /> t <br /> - ):;;.?r.:_a;;,...:�•e:.,,c:;_i_;.(' 6-20 Gal. <br /> Health Permit NandwashWaler <br /> Sterna+v/Champ <br /> Plsf <br /> E'apsrHand'rowals s <br /> Soap dispansar <br /> CuttingPaard Sanifizerbuckel- <br /> bleach 8 Watarfor <br /> Propane Slave Bleach storing wlptnU dalhs <br /> Booth must be on { <br /> Concrete,Asphalt, <br /> i Iln''' ;-' Plywood,or a Tarp. <br /> .. ,gin. -.• -. -._..,: <br /> 9oo., <br /> Soap and Waler Rirse Walar Bleach and Water Garbage <br /> can <br /> Ftro Exlhmulsher <br /> Walef 7f� <br /> v ice Cooler <br /> L> (;::t-::;':;:itt_°_ 6Galliandwash <br /> Extra Ice Bags 3 Food Cmdalnars mus!be /'� Wastewater CoMalnar 7 <br /> ----- - -- ` stored 6 Inches off of the groundl ' <br /> 9gi <br /> t <br /> i <br /> EHD 10-02 Page a of 11 TEMP EVENT APP <br /> 7/14116 <br /> 3 <br />