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10. 1 am providing the following cold temperature control for the cold ho#ding 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 ❑ Ice bath and tubs <br /> ❑ Other(specify) <br /> 11. 1 am providing the following items within my booth for warewashing: <br /> El 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 /> separate tub (bucket or basin) for the collection of rinsetwastewater. Paper towels and a pump-style soap <br /> container. <br /> 14. Names of respo Ible persons to lie 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 /> II ? ff <br /> 15. Completed by: ESY��z <br /> Signature Tit a Da e <br /> S iL Ga,. S <br /> Health Permit "and wasi Water <br /> Slerna wlGhaf'np <br /> L'1sh 1 <br /> PaFer land 7eweis <br /> Soap Jsper;ser <br /> 7 <br /> CtlGrg Board SanlUzer bucket- <br /> bleach&water far <br /> stop ng wlping cloths r <br /> I'rapana Stove 81gar,� FFI <br /> F <br /> Booth must be on l <br /> Concrete,Asphalt, ! <br /> Plywood,or a Tarp. <br /> Soap ana Water R,nso water aesch and WRIor Garbage f <br /> Can !{}V <br /> Fire Extl.nqulsner <br /> extra } <br /> Water ,I}i}{ <br /> Ice Cooler !� 5GelI{and wash <br /> I Lxfra km Begs 3 Food conlalnars must to Wastowalor Container <br /> —---- ---- —•—�` stoma'6 fnrhos off of the gmundl <br /> END 16-02 Page 8 of 11 TEMP EVENT APP <br /> 7114115 <br />