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I <br /> f <br /> 10. 4 am providing the fallowing cold temperature control for the cold holding of potentially hazardous foods below <br /> 45°F(if food is used the following day,maintain below a i aF 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 /> Q 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 or water). <br /> El 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 warm water at a minimum of 100T(i.e.5-20 ga€ion container with spigot). <br /> ❑Ona separate tub(bucket or basin)for the collection of rinselwastewator. <br /> ❑ Paper towels and pump- Ie soap container. <br /> 13. dames of responsible perso S o be prese in booth during all hours of op tion; <br /> portant All f endor booths are sub act to inspection. F'laase make a copy of this appiicatlan 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 ort [nal to festival coordtr+atar three weeks tier to <br /> this�nt. <br /> 14. Completed by: <br /> 5 ature 'title Date � <br /> Health Permit sz� <br /> wlCheirnp Hand+wash LYalme <br /> Alan <br /> pee..t4c+a row�Fs - <br /> 6oav diwauor <br /> C4el4rq t3emld <br /> SaniCrx trx3oab <br /> taaecn m Mwx for <br /> Roaana s�+e Bi..ach �g rbou <br /> Booth must be on <br /> Caurete,A9pbO, <br /> Propar4 rank E'IywoOd,or a Tar <br /> p. <br /> RwperxlV�aar rLmaWoWr FlioatltandWatar Csaf�BQB ' <br /> Fire E4rguaMf - <br /> Can <br /> wolx <br /> Ice Cooler 6palHsndw.ah <br /> EA"1u6 aepa A FOW VMfOkMif Mit D. vra:leHatar ca+tur ar <br /> Mand A kuhar,nlrorU�u prwmdl „�„�. <br /> EHp 18-02 pgg4 B o4 i t TEMP EVENTAPP <br /> 08rOrlfB <br />