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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'F temperature): <br /> ❑ Ice chests ❑ Refrigerator <br /> ❑ Refrigerated truck ❑ Ice bath and tubs <br /> ,Other(specify) <br /> 11. 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 /> isolution(one tablespoon of bleach per gallon of water). <br /> X <br /> Cd ❑ 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 /> preparation for this vent. A copy of this checklist must be in the booth at all hours of <br /> preparation and op ration. Return original to festival coordinator three weeks prior to <br /> this even - <br /> 14. Completed by: <br /> Stgnat re Title <br /> Date <br /> 5-20 Gal. <br /> Health Permit Hand wash Water <br /> Sterno w/Chaffing <br /> Dish <br /> Paper Hand Towels <br /> Soap dispenser <br /> Cutting Board Sanitizer bucket- <br /> bleach&water for <br /> Propane Stova <br /> Bleach storing wiping cloths <br /> Booth must be on <br /> Concrete,Asphalt, <br /> . •r f Plywood,or a Tarp. <br /> Propane Tank -. ___.._..,.......��....�. .- .k_..a�.� ._.�...,.W..u..� ..._,....._.. <br /> Soap end Water Rinse Water Bleach and Water Garbage <br /> »s Can <br /> Fire Extinguisher <br /> Water <br /> t <br /> Ice Cooler 5Gal Hand wash <br /> Extra Ice Bags 8 Food Containers must be Wastewater Container <br /> stored 6 inches off of the ground! <br /> EHD 16-02 Page a of 11 TEMP EVENT APP <br /> 06/01/16 <br />