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10. 1 am providing the following cold temperature control for the cold holding of potentially hazardous moods below <br /> 45°F(if food is used the following day, maintain below 41°F temperature): <br /> Ice chests Refrigerator <br /> ❑ Refrigerated truck ❑ Ice bath and tubs <br /> n Other(gnecify) <br /> 11, 1 am providing the following items within my 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 /> solution(one tabiespoon of bleach per gallon of water). <br /> Detergent, bleach, and wiping cloths(cleaning towels). <br /> Test strips to measure sanitation levels for bleach solution measuring 100ppm. <br /> Tub to store wiping cloths in bleach solution measuring 100ppm. <br /> 12. I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br /> booth: <br /> 4 <br /> DWater supply dispenser with warm water at a minimum of 100°F(i.e. 5-20 gallon container with spigot). <br /> One separate tub(bucket or basin)for the collection of rinse/wastewater. <br /> Paper towels and pump-style soap container. <br /> 13. Name es nsib► n "to be present booth during all hours of operation: <br /> rxp,„a..vo,ra ,eoarx M f ..rt .,fpnrinjr mY nthc are c. ;h}acf fn ir, ntanfin Please make a rnnv of tbs,ig aV, iC..M on. 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 2rior to <br /> this ent. `> <br /> 14. Completed by: � �� 7 <br /> `- SIgnature Title Date <br /> 5 20 Gal. <br /> Health Permit �Hend wash Water <br /> Stern.w/Chaffing <br /> Dish <br /> Paper Hand Towels <br /> Soap dispenser <br /> Cutting Board sanitizer bucket- <br /> bleach&water for <br /> —ITc ——1——1 // , <br /> ( 1 {� r storing wiping cloths <br /> Booth must be on <br /> Concrete,Asphalt, <br /> Plywood,or a Tar}. <br /> Propane Tank <br /> Soap and Water Rinse Water Bleach and Water ty arh-gp <br /> Can <br /> Fire Extinguisher <br /> Extra <br /> Water <br /> Ice Cooler ? 5 Gal Hand warn <br /> Extra Ice Begs&Food Containers must be Wastewater Container <br /> END 16-02 Page 8 of 11 TEMP EVENT APP <br /> 811/14 <br />