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10. 1 am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br /> 457(if food is used the following day, maintain below 41°F temperature): <br /> ce 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 /> hree 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 /> olution(one tablespoon of bleach per gallon of water). <br /> 12. lam providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br /> 'Petergent, bleach, wiping cloths (cleaning towels), and a tub to store wiping cloths in bleach solution. <br /> I; <br /> li am providing the following for adequate hand washing facilities, but separate from utensil wash within my booth:\Zpv r <br /> ater supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). A i <br /> eparate tub (bucket or basin) for the collection of rinse/wastewater. Paper towels and a um -s le soa �I <br /> container. !3 <br /> t <br /> 14. Names of responsible persons to be present in both 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 oricilinal to festival coordinator three weeks prior to <br /> this event, <br /> I <br /> 15. Completed by: (1 y <br /> Signature Title Elate <br /> 5-24 Gal. <br /> Health Permit Hand wesh Water <br /> Sterno wlChatfing <br /> LDish i <br /> Paper Hand <br /> Hoard Towe]s i <br /> Soap dispenser l <br /> Cutung Sanilizer bucket- <br /> bleach&water for <br /> Propane Slovo Bleach storing vdping aolhs <br /> Booth must be on I <br /> Concrete,Asphalt. <br /> Plywood,or a Tarp, <br /> Propane Tank - - — - - <br /> Soap end Water Rinse Water Bleach and Waler Garbage <br /> Can <br /> Pre EzKnpulsher <br /> Cxlra <br /> Wafer <br /> Ice Cooler 5 Gal Hand wash <br /> F�ira Ice Saps 3 Foadcoalaoafs must be Wastewaler Container <br /> slarod 6lnchos a!!af the proundl <br /> I� <br /> EHD 16-02 Page B or 11 TEMP EVENT APP 1 <br /> 7114116 <br />