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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 OF temperature): <br /> ❑ Ice 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 utensil <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 /> SkWater supply dispenser with warm water at a minimum of 100"F(i.e.5-20 gallon container with spigot). <br /> gone separate tub(bucket or basin)for the collection of rinse/wastewater. <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 /> ,.0 <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. Rejurn orao*nal to festival co2idiLlalgr three weeks prior to <br /> Xhl e /� <br /> 14. Completed by: -- -- +- 07 ,e,.. <br /> Signature title pate <br /> -- s70 Gat----- <br /> Eland wash Water <br /> Health Permit <br /> ig <br /> St9rlwwrChaffa ,y. <br /> Olsh <br /> Paper Hand Towels <br /> l Sapp d - <br /> Cuttin¢Bonrd &IIAaer budel- <br /> _ bleach&waiter for <br /> Propane Stove Bleach 610hngwiping eWlhtt <br /> t3001h rot' be o <br /> Concrete, Asphalt, <br /> Plywood,or a Tarp. <br /> Propane Trutt <br /> soap and WAtnr Rmao Walru Otearh and water Garbage <br /> 1 Can <br /> _ rireFxlirguishor �- <br /> Ice Cooler SCiai Hend wash <br /> Fkrfa!ce/jags d Food Confainars must ha WaitewalorContainer <br /> stared 6 echos o!1 al rho 9nuwdf <br /> EHD 16-02 Page 8 of 11 TEMPEVENTAPP <br /> 0715117 <br />