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10. 1 am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br /> 450F (if food is used the following day, maintain below 41'F temperature); <br /> ❑ Ice chests ❑ Refrigerator NIA Prepackaged Non Potentially <br /> ❑ Refrigerated truck ❑ Ice bath and tubs Hazardous Goods <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). NIA Prepackaged Non Potentially <br /> ❑ Tub to store wiping cloths in bleach solution. Hazardous Goods <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 /> ❑ Paper towels and pump-style soap container. <br /> 13. Names of responsible persons to be present in booth during all hours of operation: <br /> Patricia Vermilus <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 oper Lion. Return original to festival coordinator three weeks prior to <br /> this event. y/ <br /> 14. Completed by: n <br /> Signature Title Date <br /> 5-20 Gal, <br /> Health Perm i# Hand wash Water <br /> S[emo wlChaffing <br /> Dish <br /> Paper Hand ToweSs <br /> Soap dispenser <br /> Cuttinq Board Sanifizer bucket- <br /> bleach&water for <br /> Propane Stove Bleach <br /> storing wiping cloths <br /> Booth must be on <br /> Concrete,Asphatt, <br /> Plywood,or a Tarp. <br /> Propane Tank <br /> Soap and Water Rinse Wa[er Bleach and Water <br /> Garbage <br /> Can <br /> Fire Extinquisher <br /> ExEra <br /> Wa[er <br /> Ice Cooler 5 Gal Hand wash <br /> Extra Ice Begs&Food Containers must be Wastewater Container <br /> stored 6 inches off of the ground? <br /> EHD 16-02 Page 8 of 11 TEMP EVENT APP <br /> 08/01116 <br />