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am providing the following I temperature control for the cold holding otentially hazardous foods below <br /> 45°F (if food is used the foiivvving day, maintain below 41°F temperature): <br /> ❑ Ice chests ❑ Refrigerator <br /> El Refrigerated truck ❑ Ice bath and tubs` <br /> ❑ Other(specify) Z_e� <br /> 1. I am providing the following items within my booth for warewashing: <br /> Three compartment sink. <br /> OR <br /> ❑ Three deep tubs (basins E-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 /> [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 /> Lv� Water supply dispenser with warm water at a minimum of 100°F (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 pump-style soap <br /> container. <br /> 14. Names of responsible persons t]o� be p <br /> rese <br /> nt in booth 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 original to festival coordinator three weeks prior to <br /> this event. <br /> 15. Completed by: L <br /> Sign. at Title Date <br /> 5-20 Gal. <br /> Health Permit <br /> rno wlChaffino <br /> Dish r <br /> Paper Hand Tpwals <br /> Soap dispenser <br /> Cutting Board <br /> 5ani 1 bucket- <br /> blearh&water for <br /> Propane Store Bleach storing wiping doffis <br /> Booth must be an <br /> 74 <br /> _ Concrete,Asphalt, <br /> Plywood,or a Tarp. <br /> Propane Tank <br /> Soap and Water Rinse Water Bleach and Water <br /> Garbage <br /> -- Fire F_xfinguisher <br /> Can <br /> extra <br /> Water <br /> Ice Cooler � 5Gai Hand wash <br /> Extra Ice Sags&Food Containers must be Wastewater Container <br /> stored 6 inchos aHof the ground! <br /> EHD 16-02 Page 8 of 11 7114115 TEMP EVENT APP <br />