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5u. i aryl providing the following cold temperature control for ti-te cold i-toic ing of potentiali// I rdous foods beiovv <br /> ' 45°F(if food is used the following day, maintain below 41 OF temperature): A` i � / <br /> A 4" <br /> ❑ Ice chests ❑ Refrigerator <br /> ❑ Refrioerated 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: v ' <br /> ❑ Three compartment sink. <br /> OR <br /> LJn for Three deep tUuS ,baSiilS 6-8 inches titiitiliiuiit/, one wt soapy water, Dire fur iinsing and one fC1`01- a blcaCh <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 /> ater supply dispenser with warm water at a minimum of 1007 (i.e. 5-20 gallon container with spigot). <br /> One separate tub(bucket or basin)for the collection of rinse/wastewater. <br /> aP-aper towels and pump-style soap container. <br /> 13. Names of responsible Personsty 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 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 /> �& . 1 <br /> 14. Completed by: "Ak '� �� int 1 I <br /> 11-7 <br /> Signature Title Jate <br /> 5-20 Gal. <br /> Health Permit Hand wash Water <br /> Stemo w/Chaffing <br /> Dish <br /> Paper Hand Towels <br /> - Soap dispenser <br /> cultina Board Sanilizer bucket- <br /> bleach 8 water for <br /> Propene Stove <br /> Bleach storing wiping cloths <br /> Booth must be on <br /> Concrete,Asphalt, <br /> Plywood,or a Tarp. <br /> Propane Tank - - - <br /> Soap and Water Rinse Water Bleach and Water Garbage <br /> Can <br /> Fire Extinguisher <br /> Extra <br /> Water <br /> Ice Cooter ` 5 Gat Hand wash <br /> Extra Ice Sags&Food Contatners must be - Wastewater Container <br /> stored 6 inches of of Me ground! <br /> EHD 16-02 Page 8 of 11 TEMP EVENT APP <br /> 08/01/16 <br />