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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 /> `pgoe 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 /> ❑ 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 100°F(i.e. 5-20 gallon container with spigot). <br /> ❑ One separate tub(bucket or basin)for the collection of rinsetwastewater. <br /> ❑ Paper towels and pum�sty[e soap container. <br /> 13. Names of res onsible persons to be resent in booth durin all hours of operation: <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: L Z 3 <br /> Si atu Title Date <br /> �.f <br /> =5-2.10 . <br /> Health Permit ater <br /> Stern wChatting <br /> Olsh <br /> Paper Hand Towels <br /> Soap tlisp�sor <br /> L'utting Board Sanitlzer bucket- <br /> bleach&water for <br /> P=,noon SY,vn Bleach shlrirg wiping dolhs <br /> Booth must be on <br /> Concrete,Asphalt, <br /> Plywood,or a Tarp. <br /> Prnaane Tank �+[ + r <br /> _:F:��," Soap erd Water Rmea Watwr Rlearh and Wata* Garbage <br /> I Can <br /> Fire Ezlirguisher <br /> F�ua <br /> wsror <br /> ri <br /> Ice Cooler 5 Gal Hand wash <br /> f FaWa Ice Pisgs&Food Co takmrs must be Wastuwalor Coclalner <br /> J sforod B Inches off of the groundl <br /> EHD 1"2 Page 8 or 11 TEMP EVENT APP <br /> 08/01/16 <br />