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10. . I 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 ❑ 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 100°F (i.e. 5-20 gallon container with spigot). <br /> ❑ One 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 /> "Important" All food vendor booths are subject to inspection. Please make a copy of this application in <br /> prep tion for this event. A copy of this checklist must be in the booth at all hours of <br /> pre arati and operation. Return original to festival coordinator three weeks prior to <br /> thioev nt. <br /> 14. Completed by: ,.- ' <br /> .-' Signature Title Oate <br /> -t 1i�, IIgR i1�41 <br /> 5-20 Gal. <br /> Health Permit Hand wash Water <br /> Stemo w/Ch ffing <br /> Dish <br /> Paper Hand Towels <br /> Soap dispenser <br /> Cutting Board Sanifter bucket- <br /> bleach 8 water for <br /> Propane Stove Bleach <br /> storing wiping cloths <br /> Booth must be on <br /> Concrete,Asphalt, <br /> Plywood,or a Tarp.7` s ., <br /> ;_. <br /> r Soap end Water Rinse Water Bleach and Water <br /> Garbage <br /> FiCan <br /> re Extinguisher <br /> Extra <br /> Water <br /> Ice Cooler <br /> �� 5GalHandwash <br /> Extra Ice Bags 8 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 /> 06/01/16 <br />