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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 /> efrigerated truck ❑ Ice bath and tubs <br /> Other(specify) <br /> 11. I 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 /> etergent, 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 100°F(i.e. 5-20 gallon container with spigot). <br /> ❑One separate tub (bucket or basin)for the collection of rinse/wastewater. <br /> aper towels and pump-style soap container. <br /> 13. Names a# sponsible persons to be�pPresent irybooth during all hours of operation: I <br /> ill") /I :'�ft 1 <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 /> Sterno wlChaffng <br /> Dish <br /> Paper Hand Towels <br /> Soap dispenser <br /> Cutting Board Sanitizer bucket- <br /> bleach&water for <br /> I Propane Stove Bleach <br /> storing wiping Goths <br /> Booth must be on <br /> Concrete,Asphalt, <br /> Plywood,or a Tarp. <br /> Propane Tank <br /> a' Soap and Water Rinse Water Bleach and Water <br /> Garbage <br /> Can <br /> Fire Extinguisher <br /> ., Vii"^ Water <br /> (Ce Coole ..... M 'R!, 5Gal Hand wash <br /> Extra!ce flags B Food Containers must be Wastewater Container <br /> stored 6 inches off of the ground, <br /> EHD 16-02 Page 8 of 11 TEMP EVENT APP <br /> 7f28.!10 <br />