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i <br /> I <br /> �I <br /> i <br /> Ij ! <br /> 10. 1 am providing the foiloovint 'cold emperature control for the cold holding of potentially hazardous foods b�alow <br /> 45Ar(if ood is used a i, I win day,malnta'rn below 41°F temperature). <br /> j; <br /> Ica chests 1 efrigeratvr <br /> ❑Refrigemted truck I Ice bath and tubs <br /> ❑Other(s{rscify) <br /> i <br /> 11. I err; providing the foil 1r1g}''ems,!'thln my booth for warewashing: <br /> r <br /> El Three mpartment ink I j <br /> OR <br /> ! <br /> Three <br /> deep tubs(basInsi 6-8 i' hes minimum), one for soapy water, one for rinsing and one for a bleach <br /> solution(one tablespoor of each Ser galbn of water). <br /> 12. lam provid' g the follows lvgith ms in my booth for the sanitary cleaning of food preparation utensils: <br /> etergent,bleach,wjlqng oths cleaning towels),and a tub to more wiping sloths in bleach solution. <br /> II <br /> 13. 1 am providing the fallow&g fq'ri'adeq6te hared washing facilities,but separate from utensil wash within my booth: <br /> ater swpply dispen er Ith w rm w <br /> Y� ateT at a rinlnimum of 100 F(I.e, 5-20 gsil4n container with spigot). A <br /> separate tub (bucket or b9 ) for the collection of rinselw,astewater. Paper towels and a um s e so <br /> container. <br /> 14_ Names f res GIN MID to b I resent in booth wring all hours of operation: <br /> I G <br /> i <br /> "lrnportant*` All food ve' dor ootfts are subfect to Inspection. Please make a copy of this application In <br /> preps t i for Iris event. A copy of this checklist must be in the booth at all hours of <br /> preps tiOrl and peration. Return artnirral to festival coorainator three weeks prior to <br /> thls eniti - <br /> 15. Completed by: <br /> tgnature <br /> Title Date <br /> i <br /> Health Permit rw=w„o, <br /> papas Mend 7nweia <br /> BoeP QisPensPf <br /> GutlMng�Defd <br /> Ser56t�r LuGcel- <br /> I blaach a walr for <br /> P�vpene 31eva Bleach storing WAp;"dlalh5 <br /> I <br /> 1500th MU8t bo on <br /> phmt <br /> Ptywrwd.o a Tarp, <br /> Propene Tank <br /> I <br /> l <br /> SW IMWgier Mnm Star 9badierdWare< Garbage <br /> Can <br /> !�r <br /> Ice Cooler e 13al} <br /> am V-Pat <br /> QYra 7oB Foo a• wo tee W&tto�vl"coniainw <br /> seared EAchee Borg Qroeadf <br /> I <br /> r <br /> i r <br /> EMD 16-02 ! I <br /> 7r14115 i i Page 8 or i 1 TF-MP EVENT A" <br /> r <br /> l <br /> 1 <br /> I'I <br />