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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 /> dl ce chests ❑Refrigerator <br /> - ❑ Refrigerated truck ❑ Ice bath and tubs <br /> ❑ Other(specify) <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 /> ❑Water supply dispenser with warm water at a minimum of 1007(i.e. 5-20 gallon containerwith spigot). <br /> ❑ One separate tub (bucket or basin)for the collection of rinse/wastewater-..�---F-ql /tom <br /> ❑ Paper towels and pump-style soap container. ��,�,�, <br /> 13. Names of responsible persons to be present in booth during all hours of operation: <br /> r <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. Retum original to festival coordinator three weeks prior to <br /> this event. <br /> n: <br /> 14. Completed by: � fl <br /> Signature Title Date <br /> 5-20 Gal. <br /> Health Permit Haru1 wash Wager <br /> Sterno w/Gwfting <br /> Dish <br /> Paper Hand 7a.vda <br /> Snap dapenmr <br /> Cutang Board <br /> Sanitharbudtat• <br /> oleo,a Katy" <br /> Wcpare Stove Bleaeh Stolirisi w`.pinp doff <br /> Booth must be on <br /> Concrete,Asphalt, <br /> � rte., •4 ,� <br /> t Y. Soap and Water Asa Water aleach and Water Garbage <br /> Fre Etiaingusher Can <br /> ,..... Exna <br /> . Weler <br /> Ice Cooler I <br /> .� :.. .. ... .. ... _ ... .- s Gd Hang wash <br /> Er!r.fee Bags d food Ccntamers Host oe ewatar CordatW <br /> sla2v'6 inehes off of the g.wnd! <br /> EMD 16.02 Page 8 of 11 TEIdP EVEN-APP <br /> ?l28r,C <br /> £'d 0zVt'89£60Z iea}ueO esey4O e0Z:60 91, 91, qe-=1 <br />