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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*F temperature): <br /> ®Ice chests ❑Refrigerator <br /> ❑Refrigerated truck ❑Ice bath and tubs <br /> I]Other(speci �Q_;_Z s- - L__J , <br /> 11. I am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br /> OR Three compartment sink. <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 /> [I detergent,bleach,and wiping cloths(cleaning towels). <br /> ❑Tub to store wiping cloths in bleach solution. <br /> 12. l 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 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 pum -s Ie soan container. <br /> 13. blames of responsible persons to be present in booth during all hoursof 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 ent. <br /> 14. Completed by: S� � —7 4 t� <br /> SPgr ure Title safe <br /> 5,20 Gal. <br /> Health Permit Hand wash Water <br /> Stemst+lChalfing <br /> a.n <br /> _ Paper Nand Ta s <br /> Mead,a <br /> Soap dispenser <br /> a,istg eoaa <br /> Sarrfizor budcor- <br /> Prcpano Stovestoring <br /> water 1« <br /> Bleach storingwi ingdoths <br /> =n.,eSMph..,1'1',, <br /> Propane Tank <br /> ? Soap and Water Rinse Wafer Breach arxi Water <br /> Garbage <br /> A5:�;: . y Can <br /> r1re Extingcisher <br /> Ice Cooler k <br /> 5 Gal Hand wash <br /> Esfra rcr Bags 6 FaodCoMalnor5 rulst be Whstewalcr conlalner <br /> stored G InCAes ollW 6So ground! <br /> EHD 96A2 Pago 8 of 17 <br /> 7/2ario T[MP EVENT APP <br />