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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 warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigct)_ <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 /> Mn !'riFrl SnJt'P-hP n�UIT <br /> r _0J <br /> "Important" All food vend6f 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 /> 311512026 <br /> 14. Completed by: -fna tno <br /> Signature Title <br /> S20 Gal <br /> Health Permit Hand wash Water <br /> Slerno wlChafhrsg <br /> Msh <br /> Paper Hand Towels <br /> Soap dispenser <br /> C GWhnq f30ard Sa niU2er bucket <br /> bleach&water for <br /> sloring wpong Cloths <br /> Propane Slue Bleach <br /> Booth must be on <br /> Concrete,Asphalt, <br /> Plywood,or a Tarp. <br /> Propane Tank .���.._� __.. =.0 ram....::..:..:. ..._.. :.___., _ �•...�`.t.Ti <br /> Soap and watt, Rmse 4Valer Bleach and Water Garbage <br /> Can <br /> Fire Ezlmpwsher <br /> Eara <br /> Wafer <br /> .r, <br /> Ice Cooler 5 Gal Hand wash <br /> Erfra Ice gags d Food Conlainer5 rnual be Wastewater Containe! <br /> slorad 61nches oHa!Ibe groundl <br /> 1=1io 16-02 Page 8 of 11 TEMP EVENT APP <br /> 08101116 <br />