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PLW <br /> 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 bath and tubs <br /> ❑ Other(specify) ` <br /> t <br /> 11. 1 am providing the following items within my booth for warewashing: <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 /> 12. 1 am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br /> ❑ Detergent, bleach, wiping cloths (cleaning towels),and a tub to store wiping cloths in bleach solution. <br /> 13. 1 am p (ding the following for adequate hand washing facilities, but separate from utensil wash within my booth: <br /> Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). A <br /> separate tub (bucket or basin) for the collection of rinse/wastewater. Paper towels and a pump-style soap <br /> container. <br /> 14. roes of responsible per to be pr sen in ooth durinJall 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 /> 15. Completed by: <br /> Signature Title Date <br /> Mff��t5-20 Gal. <br /> Health Permit Sterno w/ChaHand wash Water <br /> ffing <br /> Dish Paper Hand Towels <br /> Soap dispenser <br /> Cuff ng Board Sanitizer bucket- <br /> bleach&water for <br /> Propane Stove <br /> Bleach storing wiping cloths <br /> Booth must be on <br /> Concrete,Asphalt, <br /> Plywood,or a Tarp. <br /> "' y� Soap and Water Rinse Water Bleach and Water Garbage <br /> :.. Can <br /> Fire Extinguisher <br /> _ _ Extra <br /> Water <br /> Ice Cooler ;I P4"`' ' °6 " ' 5 Gal Hand wash <br /> Extra ice Begs 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 /> 7/14/15 <br />