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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°F(if food is used the following day, maintain below 41°F temperature): <br /> ❑ Ice chests• ❑ Refrigerator <br /> Refrigerated truck ❑ Ice bath and tubs <br /> ❑Other(specify) <br /> 11. 1 am providing the following items within my booth for.warewashing: <br /> ❑Three compartment sink. I <br /> '4 <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. I am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br /> ❑ Detergent, bleach,wiping cloths(cleaning towels), and a tub to store wiping cloths in bleach solution. <br /> 13. 1 am 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 /> 14. Names of responsible persons to be present in booth during all hours of operation: <br /> 9 <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 <br /> 15. Completed by: �5 i <br /> Signature Title Date <br /> 5-20 Gal. 9 <br /> Health Permit Hand wash Water <br /> x <br /> Slerno w/ChafOng _ <br /> Dish <br /> Paper Hand7nwels u <br /> ' Soap dispenser j <br /> cutting Board San lwc f <br /> ilizer ket- <br /> bleach&water for <br /> Propane Stove <br /> Bleach storing Mping cloths <br /> Booth must be on <br /> Concrete,Asphalt, <br /> O; �' Plywood,or a Tarp. j <br /> Propane Tank ' ... . ._.. ._ - ... .... .... .. ._ ..' .._..:....'... ._.,. �.-_..._:.. _. ..—...- ---..-....._..._.. <br /> 3 <br /> f: <br /> Soap and Water Rinse Water Bleach and Water Garbage it <br /> _. Can <br /> Fire Extinguisher - <br /> Extra � <br /> Water a <br /> 5 <br /> b <br /> u <br /> rice Cooler 4':" "'' `" ' '' 5 Gal Hand wash <br /> Extra Ice Bags$Food Containers must be Wastewater Container s <br /> -•---•--••-•----------•--•' stored Benches offofthe groundl =i <br /> EHD 16-02 Page 8 of 11 TEMP EVENT APP <br /> 711 A115 <br />