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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 OF temperature): <br /> ice chests ❑ Refrigerator <br /> ❑ Refrigerated truck ❑ Ice bath and tubs <br /> ❑ Other(specify)_ <br /> 11. 1 am providing the fo[lowing items within my booth for the sanitary cleaning of food preparation utensils: <br /> Three compartment sink. <br /> OR <br /> ❑ Three deep tubs (basins 6-3 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 rinse/wastewater. <br /> P Paper towels and pump-style soap container. <br /> 13. Names of responsible persons to be present in booth during all hours of operations:? tl <br /> G U tr + a f�1r. o f <br /> � f <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, Retum original to festival coordinator three weeks prior to <br /> this event. <br /> 14, Completed by: <br /> Sig nature;-"'r Title Date <br /> s.�0 cap <br /> Health Permit Haryd wash Waw <br /> S;erno wrchaHing <br /> aish <br /> paper Hand Towels <br /> LseaP dispenSlr <br /> Cv ma H zr <br /> oard I sanq� t byckel- <br /> ble"h a water for <br /> Propane Stove preach storing w-ping Cloths— <br /> Booth must be on \ <br /> U Concrete,Asphalt. <br /> Plywood,or a Tarp. <br /> FrUpane Tank <br /> s soap anq Water I Rinu Wrer 1 I Bleach r'd Water I Garbage <br /> 1 p I caR <br /> Frc E�4nptns'�er <br /> jllll�-C�^-C'11�111� A Warlr <br /> Ice Cooler 5Gat TSand wa <br /> F6srra Ice Begs$Foos Corrramees mast to Wastewater eonta,rw <br /> $rore�e 6Inenes off flit grourIM �1 <br /> ENO W-02 Page 8 of 11 TEMP EVENT APP <br /> 0810T116 <br />