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ME <br /> 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 /> p Other(speciry) <br /> It. I am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br /> ❑Three compartment sink. <br /> OR <br /> deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br /> AThree <br /> tion(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 /> I <br /> Liq <br /> Water supplydispenser 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 pumo-style soap container. <br /> 13. Names of responsible persons to be present in booth during all hours of operation: <br /> — ED;t,Jd a Ll l? — — — — — — —- <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 twee weeks prior to <br /> is event. <br /> 14. Completed by: L/ q t0! 2 2 <br /> ture Title Date <br /> s2o r.i <br /> Health Permit <br /> steno NlCharhng <br /> 0!sh <br /> Paper Hand Toasts <br /> SaaP Anpnwer <br /> Cullom Hoard San&zer buclwt- <br /> bleach5 water For <br /> Pmy�arM Sbv'e Hle ch slmng wprng dams <br /> Booth must be on <br /> Concrete,Asphalt, <br /> Ptywood,or a Tarp. <br /> ProvaneTank _. . <br /> soap.nd wabr Rfnx Wf�or Bbadf r,d way Garbage <br /> Can <br /> File Ezenpu�er <br /> `��;�, 6eb•r <br /> Ice Cooler 5 Gat Hand cosh <br /> Exits rae Hops A Foci Carte mat corftal> <br /> �I sRiad 6 i�haS olld tna prow' <br /> END 16-02 Page 6 of 1 i TEW EVERT APP <br /> f]Er0ii1$ <br />