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L � <br /> 8, 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 /> YJ Ice chests ❑Refrigerator <br /> ❑Refrigerated truck Vice bath and tubs <br /> ❑Other(specify) <br /> 9. f am providing the following items within my booth for the sanitary deaning of food preparation utensils: <br /> ❑Three compartment sink. <br /> OR rJ�.�( <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 /> 10. 1 am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br /> booth' <br /> le 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 /> Paper towels and oump-pWe soaQ container. <br /> 13. Names of responsible persons to be present in booth during all hours of operation. <br /> �Mirh3p_l P;?r nr katiP hrnntn _ <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 orlalrial to fw1valr thMl weeks prior to <br /> this qven� <br /> l ow , of February 22, 2022 <br /> 14. Completed by: � � <br /> Signature T e Date <br /> 520 Gr / <br /> Health Permit 5 H .LnWra J� <br /> Owi PLpLr FWq Tore <br /> scp dnoMw <br /> p,yp,o Ma,y SLnexu War <br /> P.op�59ve &O� ��wwq dVSY <br /> Booth be on <br /> Cnorrte.Asphan.Plywood,or a Tarp <br /> PiopLne rLnk , ���� <br /> SOLp pr,e Wrw Rnrr WLnr BM[T ma WMs � Garbage <br /> Can <br /> n <br /> iro r'nninr _ SGU Hrw.w, <br /> Errs Ip Spf L Food Cmrrwn ndq M WMLrMM k.0 <br /> ' eraiad s ncnas sirdme pnwna <br /> EHO is-w Pao.a sir 11 TEMP EVEW APP <br /> VYI3MQ <br />