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I <br /> 4 <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 �/Jce bath and tubs <br /> I <br /> ❑ Other(specify) <br /> 11. 1 am providing the following items within my booth for warewashing: <br /> ❑Three compartment sink. <br /> OR <br /> Imo'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 /> 1 <br /> Q/Detergent, bleach, wiping cloths (cleaning towels),and a tub to store wiping cloths in bleach solution. F <br /> 1 <br /> 13, 1 am providing the following for adequate hand washing facilities, but separate from utensil wash within my booth: <br /> % <br /> O/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. N es of re ponsib/l,persons to be present in booth during all hours o peration: <br /> 7tC V-0 o(`- rr��C t e C' O[Jl [P LL Gh es rS j�c <br /> N <br /> E <br /> "hinportant" 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, <br /> G / / <br /> 15. Completed by: d <br /> Signature Title Date <br /> S7 5-20 Gal. <br /> Health Permit Hand wash Water q <br /> F" Stern w!Chafting <br /> Dish <br /> Paper Hand Towels y <br /> Soap dispenser <br /> Culling Board Sanitizer bucket- <br /> bleach&water for <br /> storing wiping cloths l <br /> Propane Stove Bleach4 <br /> Booth must be on <br /> O Concrete,Asphalt, <br /> oc ra Plywood,o Tarp. <br /> Propana Tank <br /> Soap end Walor Rinse Water Bleach and Water Garbage <br /> Can gg <br /> Fire Extinguisher <br /> Extra <br /> Water <br /> e' <br /> Ice Cooler f 5 Gal Hand was <br /> h <br /> Extra fce Bags&Food Contafneis must be Wastewater Container 3 <br /> stored 6 inches oHof the ground! <br /> 5 <br /> a <br /> a <br /> %I <br /> EHD 16-02 Page a of 11 TEMP EVENT APP <br /> 7/14115 <br />