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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 OF temperature): <br /> ❑ Ice chests ❑ Refrigerator <br /> ❑ Refrigerated truck !!! D 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 /> solution (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 /> E�IDetergent, 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 /> Water supply dispenser with warm water at a minimum of 1 GOOF (i.e. 5-20 gallon container with spigot). A <br /> separate tub (bucket or basin) for the collection of rinsetwastewater. Paper towels and a purnp-slyle soap <br /> container. <br /> 14_ Names of responsible persons to be present in booth during all hours of operation_ <br /> cr i <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: <br /> Signature Title Date <br /> 5-20 QW. <br /> Health Permit Hand wash Water <br /> Stereo wfCttalfing <br /> piste <br /> Paper HaMI rowels <br /> Saap Dispenser <br /> Cutting Board <br /> Sanitxer Cucket- <br /> bleach#water for <br /> Aropane Slovc 6leaoh storing wiping dons <br /> Booth must be on <br /> _ Concrete,Asphalt, <br /> ! f Plywood,or a Tarp. <br /> Soap antl Water Rinse Water Bleach and Water <br /> Garbage <br /> - Fire F.x7irsguSher <br /> Can <br /> F�ara <br /> !4 Water <br /> Ice Cooler 5 Gal Hand wash <br /> E-va fce Bags 8 Food Containers must be Wastewater Container <br /> stored 6+caches off oft, graexrC! <br /> EHD 1"2 Page S of 11 <br /> 7114115 TEMP EVENT APP <br />