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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 /> XIce 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 /> X 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 /> Pi 3TUJ& <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 event. <br /> 14. Completed by: ./S` QG9/ L_ Z7 <br /> Signature Title Date <br /> 5-20 Gal. <br /> Health Permit SteHand wash Water <br /> Sterno w/Chaffing <br /> Dish <br /> Paper Hand Towels <br /> Soap dispenser <br /> Cutt ng Board SaNfizer bucket- <br /> bleach&water for <br /> Propane Stove <br /> Bleach storing wiping cloths <br /> Booth must be on <br /> Concrete,Asphalt, <br /> Plywood,or a Tarp. <br /> .. <br /> t . "� �,r .• act'. <br /> Propane Tank <br /> Soap and Water Rinse Water Bleach and Water <br /> _• Garbage <br /> Can <br /> Fire Extinguisher <br /> a Extra <br /> Water <br /> Ice <br /> Cooler I 5GalHand wash <br /> Extra Ice Bags 6 Food Containers must be Wastewater Container <br /> stored 6 inches oB of the ground! <br /> EHD 16-02 Page B of 11 TEMP EVENT APP <br /> 06/01/16 <br />