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10. I 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 /> W 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 warewashing: <br /> ❑Three compartment sink. <br /> OR <br /> VThree <br /> deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br /> ution (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 /> f <br /> ."q Water 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 rinselwastewater. Paper towels and a pump-style soap <br /> container. <br /> 14. Names of responsible persons to be present in booth during all hours of operation: <br /> l <br /> in vA V� <br /> '*Important" AJI 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: J UJVt e'� (Z <br /> Signature Title bate <br /> 5.20 Gat, <br /> Health Per Hand wash Walar <br /> Sterno wlChaffrng <br /> olsh <br /> Paper Hand Towsis <br /> Board <br /> Soap dispenser <br /> Culling Sani dzer buckel- <br /> 1\ <br /> bleach&water for <br /> Propane 5rove Bleach storing wiping dnlhs <br /> Booth must be on <br /> Concrete,Asphalt, <br /> r�' O Plywood, or a Tarp. <br /> Propane Tank <br /> Soap and water Rinse Water Bleach and Wale; CarI3ggE <br /> Fire 6dinguishcr Can <br /> Esire <br /> Weler <br /> Ice Cooler 5 Gal Hand wash <br /> F�dra Ice Sags d Food Confainan must be Waslewaler Container <br /> slcrod B inches o7o/lho ground? <br /> EHD 16-02 Page B of 11 TEMP EVENT APP <br /> 7114115 <br />