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10. l 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'F temperature):101A <br /> ®Ice chests ❑Refrigerator <br /> Q Refrigerated truck ❑Ice bath and tubs <br /> ®Other(specify) <br /> 11. I am providing the following items within racy booth for the sanitary cleaning of food preparation utensils: <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 /> olution(one tablespoon of bleach per gallon of water). <br /> �FDetergent,bleach,and wiping cloths(cleaning towels). <br /> [Tub to store wiping cloths in bleach solution. <br /> 12. 1 am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br /> booth: <br /> 'Water supply dispenser with warm water at a minimum of I00°F(i.e.5-20 gallon container with spigot). <br /> One separate tub(bucket or basin)for the collection of rinsehvastewater. <br /> T�Faper towels and pump-style soap container. <br /> 13. Names of responsible perso o be present in booth during all hours of operation: <br /> aJ'-, �a <br /> =elmportant** 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 /> 14. Completed by: <br /> Signature Title Date <br /> 5-20 Gat. <br /> Health Permit hand wash water <br /> StemuwJChaFfing <br /> @sh <br /> Paper Nand Tc.:efs <br /> Soap dispenser <br /> CulUng Board SariU.r twcRe[- <br /> bleach&water for <br /> Prepano Stow &each storing wip!rg cloths <br /> t <br /> Booth mug be on <br /> f Concrete,Asphalt, <br /> Plywood,or a Tarp. <br /> ? Soap and Water Rinse Wafer Bleach and WaLr <br /> Garbage <br /> fn; _ :. r Can <br /> Fire EMirgcasher <br /> Ice "locier M SGaI}iarA wash <br /> Eslra!ce flags 6 FopdCoMarners must be lhastewalcr Contalner <br /> stored alncnes onofthe gnwrMl <br /> €HD 16.02 Page Sol 11 TEMP EVENT APP <br /> 7123110 <br />