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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 ands tubs <br /> E]Other(specify) ^ ` `a� l c- <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 tablespoon of bleach per gallon of water). <br /> ❑ 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 facilities, but separate from utensil wash within my <br /> booth: <br /> 12�water supply dispenser with warm water at a minimum of 100°F(i.e.5-20 gallon container with spigot). <br /> Ello'ne separate tub(bucket or basin)for the collection of rinse/wastewater. <br /> aper towels and pump-style soap container. <br /> 13. Names of responsible persons to be present in booth during all hours of 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 event. <br /> 14. Completed by: <br /> Signature Title Date <br /> "- 5-20 Gal. <br /> Health Permit Hand wash Water <br /> 4 Sterno w/Chaffing <br /> Dish Paper Hand Towels <br /> Soap dispenser <br /> Cutting Board Sanitizer bucket- <br /> bleach&water for <br /> storing wiping cloths - <br /> Propane Siove Bleach <br /> Booth must be on <br /> 0 Concrete,Asphalt, <br /> Plywood,or.a Tarp. <br /> Propane Tank <br /> ------------- <br /> Soap and Water Rinse Water Bleach and Water Garbage <br /> Can <br /> Fire Extinguisher <br /> Extra <br /> Water <br /> t Ce Cooler 5 Gal Hand wash <br /> FExtra Ice Bags&Food Containersmust be - Wastewater Container <br /> - - -- stored 6 inches off of the groundl <br /> EHD 16-02 Page 8 of 11 TEMP EVENT APP <br /> 08101/16 <br />