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i <br /> 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 <br /> ❑ er(specify) <br /> 11. I <br /> am Providing the following items within my booth for the sanitary cleaning of food pr taration utensils: <br /> OR ElThree compartment sink. <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 /> ❑Ti(iib to store wiping cloths in bleach solution. <br /> 12. 1 amrproviding the following for adequate hand washing facilities, but separate from utensil wash within my <br /> booth: <br /> ater supply dispenser with warm water at a minimum of 100°F(i.e. 5-20 gallon container with spigot). <br /> 0I separate tub(bucket or basin)for the collection of rinse/wastewater. <br /> aper towels and pump-style soap container. <br /> P <br /> 13. Names of responsible persons to be present in booth during all hours of operation: <br /> i <br /> t <br /> k"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 /> s preparation and operation. _Return original to festival coordinator three weeks prior to <br /> I <br /> this event <br /> i <br /> 14. ComMeted by: / <br /> L"I Signature Title Date <br /> 5.20 Gal <br /> Health Permit SteHe we <br /> Water <br /> mo w/Chatting <br /> Dish <br /> Paper Hand Towels <br /> � Soap tlispenser <br /> Ciitvnq Board <br /> Sanitize'bucket- <br /> Propane Stove bleach 8 water for <br /> Bleach slating wiping d0ths <br /> Booth must be on <br /> Concrete,Asphalt, <br /> M e Plywood,or a Tarp. <br /> Propane Tank .- , ,„ _:• r .. ,_. "'S�,�a,. <br /> Soap and Water Rinse Watar Bleach and Water W <br /> Garbage <br /> - I <br /> Fire Extinguisher Can <br /> Extra <br /> Water <br /> Ice Cool r i <br /> �_- � 3' <br /> Hantl wash <br /> t� Extra!ce Bags B Food Containers must be Wastewater Container <br /> stored 6 inches off of the ground' <br /> fi <br /> I <br /> EHD 16-02 Page B of 11 <br /> 08/01/161 B TEMP EVENT APP <br /> S <br />