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10. I am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br /> 457(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, 1 am providing the following items within my booth for warewashing: <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 /> 12. 1 am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br /> Detergent, bleach,wiping cloths (cleaning towels), and a tub to store wiping cloths in bleach solution. <br /> 13. 1 am providing the following for adequate hand washing facilities, but separate from utensil wash within my booth: <br /> Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). A <br /> s parate tub (bucket or basin) for the collection of rinse/wastewater. Paper towels and a pump-style soap <br /> container. <br /> 14. Name �ecs,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 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 /> 15. Completed by: Vl `j <br /> Signature Title Date <br /> 5-20 Gal, <br /> Health Permit HandwaShWatar <br /> Stamo wlChafFing <br /> olsh <br /> Paper Hand Towels <br /> Soap dispenser. <br /> Cuftlng Board Sanitizer bucket <br /> bleach&water for <br /> Propane Stove Bleach storing wiping cloths <br /> Booth must be on <br /> Concrete,Asphalt, <br /> Plywood,or a Tarp. <br /> Soap and Wetor Rinse Water Bleach and Water Garbage <br /> R r Can <br /> Fire EAngidsher <br /> r 45. F_xtra <br /> 01 <br /> Ice Cooler SGafHantlwash <br /> FJdfa tce Bags&Food Confafneis must6e Wastewater COntalner <br /> - ------- - stored 6 Inches offof the ground! <br /> EHD 16-02 Page a of 11 TEMP EVENT APP <br /> 7114/15 <br />