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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. I 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 8-8 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 Goths(cleaning towels). <br /> ❑Tub to store wiping cloths In bleach solution. <br /> 12. 1 am providing the following for adequate hand washing faciiities, but separate from utensil wash within my <br /> booth: <br /> ❑Water supply dispenser with warn water at a minimum of 100eF(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 VeTnilus <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: ` 2o Z 2 <br /> rgna are itle [late <br /> ate <br /> 0 Ga! <br /> Health Permit <br /> S7rrno wChaaing <br /> Di.h <br /> Asper HeM Ta.k15 <br /> so.p mspenser <br /> C,mn4 Board asr.luernucker- <br /> hlead+8 w.ler far <br /> Profane Sla+s 13�t'-r Gft Yoring wpng tlolhs <br /> Booth mum be on <br /> Concrete,Asphalt, <br /> Plywood,or a Tarp. <br /> Arppade Tank . <br /> $Oe p..d W.ler Ri—Wlwl &cac„and Wamr I Garbage <br /> Can <br /> Fkre ExtlngurJar <br /> faN.r <br /> wx� <br /> r ice Cooler SG.ifvntl«a�, <br /> Swa Ice Sags G Food Q 4a.+re muel av w.uauarei C9mnaner <br /> We ed ae.nw olia fM g wl <br /> EHp 16,02 Pup a of 11 TEMP EVENT APP <br /> awl 1 16 <br />