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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 warewashing. <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 /> sol tion (one tablespoon of bleach per gallon of water). <br /> 12. 1 am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br /> Detergent, bleach, wiping cloths (cleaning towels), and a tub to store wiping cloths in bleach solution. <br /> 13. 1 am providing the following for adequate hand washing facilities, but separate from utensil wash within my booth: <br /> 5ifwater supply dispenser with warm water at a minimum of 100OF (i.e. 5-20 gallon container with spigot). A <br /> separate tub (bucket or basin) for the collection of rinse/wastewater, Paper towels and a puma-style soap <br /> container. <br /> 14. Names of responsible persons to be present in booth during all hours of operation: <br /> CXu¢- r <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 /> 15. Completed by: `5 <br /> ignature Title Qate <br /> 5-20 Gal. <br /> Health Permit Nand wash Water <br /> Slamo wlCnafrng <br /> 13ish <br /> Paper Hand Towels <br /> Soap dispenser <br /> Cutting Board Sanitizer bucket- <br /> b€each 8 water for <br /> Propane Stove Bleach storing wiping doths <br /> Booth must be on <br /> Concrete,Asphalt, <br /> O Plywood, or a Tarp. <br /> Propane Tank - <br /> 3 <br /> Soap and Water Rinse Water Bleach and Water Garbage <br /> Can <br /> FTe Extinguisher <br /> Extra <br /> Wafer <br /> I <br /> ^IceCoofel 5 Gal Hand wash <br /> i Extra Ice Bags&Food Containers must be Wastewater Container <br /> -- -- --- Stored 6 inches ON of the gmandp <br /> EHD 16-02 Page 8 of 11 TEMP EVENT APP <br /> 7/14/15 <br />