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10. 1 am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br /> 45aF(if food is used the following day, maintain below 41"F 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 utensils; <br /> tfh ree compartment sink. <br /> OR <br /> hree deep tubs (basins 8-8 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 /> V(W'ater supply dispenser with warm water at a minimum of 100nF(i.e. 5-20 gallon container with spigot). <br /> S One separate tub(bucket or basin)for the collection of rinsetwastewater. <br /> (Paper towels and pump-style soap container. <br /> 13. Nam s of respo le pars or}s to by 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 even <br /> 14. Completed by: <br /> Signs ure Title <br /> D— a <br /> f lealth Permit H1nd Wdeh We!.r <br /> Sterno udChemng <br /> Diah Pep.r Nerd Tcwal6 <br /> soap dlepeneer <br /> eutln;y Board 9anitizer <br /> Ir. <br /> preach Z water(vr <br /> 9;onng WpinQ doth. <br /> Bleach <br /> Procan¢Stove <br /> E3 must ba on <br /> Canc2te,Asphalt, <br /> Plywood,or a Te p. <br /> 9.9.9.9. <br /> 9. <br /> Prap>ne Tank " <br /> eoep and Water Rtnsa water 91aodh and water Garbage <br /> 1>, Can <br /> 7' i.: Frre ExUnyuisher <br /> Fxtre <br /> � Vi 61er <br /> .ice Cooler $ s Gat wnd wa6h <br /> E4ra ke Bags b Fo00 GOnWera must OB Wa.kwater coraglner <br /> vorao 5 inches ae,or the Q,rovnc' <br /> E;u016-02 Page B of 11 TEMP EVENT APP <br /> 06101r16 <br />