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SA 't J 0AOUIN �s!�'��'tiEz`?`r�ili►��j ��?^r��.a� �t�?g:}�f���:EE���� <br /> 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 IN 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 utensil <br /> Three compartment sink. <br /> OR <br /> U 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 /> iX 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 100T(i.e.5-20 gallon container with spigot). <br /> ❑One separate tub(bucket or basin)for the collection of rinsetwastewater. <br /> Z Paper towels and pump-style soap container. <br /> 13. Names of responsible persons to be present in booth during all hours of operation: <br /> Jamie Griffin. Lisa Long.Tarae King or Briahna Baskett <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 anj operation. Return original to festival coordinator three weeks prior to <br /> this event. <br /> 14. Completed by ! Ut wyN;- <br /> Signattur Title Date <br /> S20 Gal. <br /> Health Permi' Mandwas�'hakT <br /> :Nano.+6ChatrsKf <br /> Parer Maud 7ove�5 <br /> J <br /> IrL�Jh\ 5anruter tndce!- <br /> 1 olRart.a rater lrn <br /> I Booth trust be on <br /> OConcrete.Asphalt, <br /> i <br /> Plywood,or a Tarp <br /> ------------ <br /> 1 S a-ar I//.,'.,r Fryv'Nat�+ 3wach and?M3[vt Garbage <br /> Can <br /> FNe <br /> Ews <br /> :Yatp <br /> Ice Cooler <br /> Ewra los Bads d Pv:v conlartes 11MC ue .Neerc.+9lcr Contsr:c+ <br /> srorec 6 nOws afl of fOw�cewiU,' <br /> Page 8 of 11 T5UP cVFNT AFT <br /> Crba'�911 y <br />