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• <br /> ( <br /> 10. 1 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,m intain below 41eF temperature): <br /> F <br /> ❑Ice chests Refrigerator j <br /> ❑Refrigerated truck ❑Ice bath and tubs <br /> ❑Other(specify) <br /> 11. 1 ant 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 /> 6d'Detergent,bleach,wiping cloths(cleaning towels),and a tub to store wiping cloths in bleach solution. l <br /> { <br /> i <br /> 13. 1 am providing the following for adequate hand washing facilities,but separate from utensil wash within my booth; <br /> o4ater 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 rinsehvastewater. Paper towels and a pump-style soar, <br /> container. <br /> - 14. Name at`yp sible.persons to be present in booth during all hours of operation: $ �' <br /> r <br /> "Important" Ail food vendor booths are subject to inspection. Please make a copy of this application In i <br /> preparation for this event. A copy of this checklist must be in the booth at all hours of <br /> preparation and operation. Return oriainal to festilval coordinator three weeks prior to <br /> th' event. I <br /> i <br /> /� naw, /15. Completed by: rJ � UNn-P�(X.,t�1�✓ ---'Date'� � <br /> signature Title 4 <br /> 6.20 Gal. <br /> Health Permit Rend wash Water <br /> Slerno w1chefrico <br /> nlsh <br /> Papor Nand Trials- Soap 4ispenser <br /> Cuit(�0 Board 8anitizer budret- <br /> bremn a water ror <br /> Bleach aloft wipin0 dollts 7i <br /> Propane Stove ,j <br /> Booth must be on <br /> Concrete,Asphalt, <br /> Plywood,or a Tarp. <br /> ........... <br /> _..---•-. .......,......._ <br /> Soap and Water Rinse Water Bleachw"w at Garbage <br /> ice'-'•h' <br /> Can <br /> Ftra ExltnptFsher <br /> �xve 3 <br /> Weler ¢ { <br /> E 7 <br /> .• T I <br /> Ice Cooler 66e1 Rend wash u <br /> Extra toe Ban$ Focdconlainamnwsibs WasleuaterContaher <br /> -y._,.r__,.,__.._,..,_.r- sloredBMctiesoNoflhogrd+nd7 � <br /> 3 <br /> 373 <br /> DID 16-02 Page 8 or 11 TEMP EVENT APP 1 <br /> 71141M i <br /> t i <br /> I <br />