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1. <br /> 4-5-5°F(if food is used the following day, maintain below 41 IF 10- am providing the following cold temperature control for the cold hofdin of <br /> g potentially hazardous foods below <br /> terrtperature): <br /> ❑Ice chests Refrigerator <br /> ❑Refrigerated truck ❑ Ice bath and tubs <br /> ❑Other(specify) <br /> 17. i am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br /> OR �Xree compartment sink. <br /> ❑ Three deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a blea <br /> solution (one tablespoon of bleach per gallon of water). ch <br /> Pf Detergent, 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 lilac, <br /> ities, but separate from utensil wash within my <br /> Water supply dispenser with warm water at a minimum of 7 00°F(i.e. 5-20 <br /> gallon container with spigot). <br /> One separate tub (bucket or basin)for the collection of rinse/wastewater. <br /> Paper towels and pump-style soao container. <br /> 13. Names of responsible persons to be present in booth d ring all hours of operation: <br /> "lrnportant*' All food vendor booths are subject to inspection. Please make a copy of this application <br /> preparation for this event. A copy of this checklist must e booth at all hours of <br /> this event, in <br /> be in th <br /> preparation and operation. Return ori final to festival coordinator three weeks prior to <br /> 14. Completed by_ <br /> gnature � v <br /> " Titte Date <br /> Health Permit - <br /> 5-20 cal. <br /> Starno w/Chaffing Hand rash Water <br /> Dish <br /> Soap dispenser Paper Hand Towels <br /> Cutting Board <br /> Propane Stove Srdtfu bucket- <br /> atBleach sbleac &water <br /> Baths <br /> Booth must be on <br /> for <br /> Concrete,Asphah, <br /> rcpane Tank .•... .....: •. -•'-.:.... Pl}rW6Dd,or a Tarp. <br /> Soap and Water Rinse Wator <br /> bleach and Wester <br /> Fire ExlinGarbagegtnshcr Can <br /> Ezra <br /> 'Nater <br /> Ice Cooler <br /> i Extra Ice Bags&Food Contairors musr be s. W 5 Gal Hand wash <br /> ._.._.._._.... ...._.._........_.. slored 6Inches off of the ground! d astewater Corttaner <br /> EHD16-02 <br /> 08f01i16 Page 8 of 11 <br /> TEMP EVENT APP <br /> g•d <br />