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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 /> ce chests ❑ Refrigerator <br /> ❑ Refrigerated truck ce 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 /> V4Tub 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 /> 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 /> 9cr-- wScx <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: AQXSQL_._V ALEPa Tp_— <br /> Si3nattlre Title Date <br /> 5-20 Gal <br /> Health Permit [Hand WashlValer <br /> Soerno wlchalGng <br /> Dish <br /> Paper Hand Tor+els <br /> Soap dispenser <br /> CWhng Bu3r(t Sanil::Lr hllCkel- <br /> bleach 8 water for <br /> sarcroane Stave <br /> Bleach l� sharing vnping cloths <br /> Booth must be on <br /> Concrete,Asphalt, <br /> Plywood,or a Tarp. <br /> Propane Tank -. <br /> Soap and Water Rinse Water Bleach aid Water <br /> Garbage <br /> Can <br /> Fire Extinguisher <br /> Ek1ra <br /> water <br /> Ice Cooler 5 Gal Hard wash <br /> Extra!x,Sags B Food Cuola(ners must be Wastewater Conta4ner <br /> stored 6 inches off of the ground! <br /> EHd 18-02 Page 8 of 11 7ree11 a TEMP EVENT APP <br />