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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 /> OR ❑ Three compartment sink. ' <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 /> ® Detergent, bleach,and wiping cloths (cleaning towels). <br /> ❑ 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 /> ®Water supply dispenser with warm water at a minimum of 1007(1,e. 5-20 gallon container with spigot). <br /> ® One separate tub(bucket or basin)for the collection of dnselwastewater. <br /> ® Paper towels and pump-style soap container, <br /> 13. Names of responslbie persons to be present in booth during all hours of operation: <br /> Kaitlyn Herron <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. <br /> 14. Completed by: _ [ V,J i/1 {� �' 5/1412025 <br /> ` Signature Tltle Date <br /> 5-20 Gel. <br /> Health Pe Ste <br /> rmit Hand wash WaEar <br /> md wtChemng <br /> D+cn <br /> Paper Hend TD.ve1e <br /> SDaD dlep[ny[r <br /> G:rtGr Board Santizerbuckak <br /> bleach 11 aaler for <br /> Propane Stove glaa� atdnng wlptnp clothe <br /> Booth must be on <br /> Concrete,A9phalt, <br /> Plywood,or a Tarp. <br /> a:e.. ..'r..%."�A r.;.�.x. . �.._. . .V4n.r .e:.S..........._ <br /> Soap and Watar Rne.Water Bleach and Water <br /> Garbage <br /> Can <br /> Fire Exttnpulehe 7r <br /> Weler <br /> 1Ce Cool elr 5 Gal Hand Wash <br /> Extra ice Baps d Food DW Nters ftwr be Wastewaler Ccntslner <br /> ----- stored dir::hes o9affhe Qmund! <br /> f L—� <br /> EHD 16-02 Page 9 of 11 TEMP EVENT APP <br /> MOV16 <br />