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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 the sanitary cleaning of food preparation utensils: <br /> ❑Three compartment sink. <br /> OR <br /> EA 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 /> Detergent, bleach, and wiping cloths(cleaning towels). <br /> EP Tub to store wiping cloths in bleach solution. <br /> 12. 1 am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br /> booth: <br /> [A Water supply dispenser with warm water at a minimum of 100°F(i.e. 5-20 gallon container with spigot). <br /> One separate tub(bucket or basin)for the collection of rinselwastewater. <br /> T" Paper towels and pump-style soap container. <br /> 13. Names of responsi a persons to be present in booth during all hole of operation: <br /> �/s i Aro J+i t'rf C z. La yonn a V A ra'P S' . <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 /> thi even . <br /> 14. Completed by: 2(2 —� C <br /> Signature Title Date <br /> 5.20 Gal. <br /> Health Permit Handwasb Water <br /> Slarno wlChaf N <br /> Dish <br /> Paper Hand Towels <br /> Soap dlepensar <br /> CuUlnp Board Sanluzer bucket- <br /> bleach E waler for <br /> Prapana 51ave Bleach <br /> Blaring wiping cloths <br /> A Booth must to on <br /> Concrete,Asphalt, <br /> Plywood,or a Tarp, <br /> Propane!ante � <br /> Soap and Watar wnea Water Bleach and water Garbage <br /> Can <br /> Fire E+dingulehar <br /> Erdre <br /> �%` Water <br /> Ice Cooler 6Gel Hand wash <br /> Exhe Ice Coss 6 food ContalfAm ffwf he Waeluwnter Container <br /> s <br /> tored 6 Whos offal tho ground! <br /> EHO 1"2 Pogue of 11 TEMP EVENT APP <br /> Df3tD1lib <br />