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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. 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). <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 wane water at a minimum of 100"F(Le. 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 /> "*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 wooks prior to <br /> this event. <br /> 14. Completed by: 4/1L0111NE_ 2q-7-3 <br /> Signature Title to <br /> Hand wash Water <br /> Health Permit <br /> Stoma wlChoflii}p <br /> Gish <br /> Paper Hand Towels <br /> Soap dispenser <br /> Culang HoarC SanrUer Oudred- <br /> Vearh&water for <br /> Fhopene Slow Heal stodng YApin9�Ne <br /> Booth must be on <br /> D concrete,Asphalt, <br /> Plywood,or a Tarp. <br /> Propane TaNc <br /> Eeap ar.7 Y1z1cr finsc ti4aer 84oarn and water Garbage <br /> Can <br /> Fna Exttrx3isher <br /> F11ra <br /> WeSEf <br /> ice Cooler sG.1.11dwae�, <br /> Ex6s ke aags C.Food CorrMUKn moat ae Wadawater contek,er <br /> --- stared 6 Mrhes Llr0a ground! <br /> EHD 16-02 Page 8 of 11 TEMP EVENT APP <br /> 081011t6 <br />