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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 ❑ Ice bath and tubs <br /> ® Other(specify) Freezer provides by SJC <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 /> t <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. lam providing the following for adequate hand washing facilities, but separate from utensii wash within my booth: . <br /> is <br /> a <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 rinselwastewater. Paper towels and a pump-style soap I <br /> container. <br /> 14. Names of responsible persons 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: Benjamin Henderson 5/5/17 <br /> Signature Title Date <br /> 5-2o Gal. <br /> Health Permlt Sterna wlC Hand wash WSW <br /> halF�ng <br /> Dlsh <br /> Paper Hand Towels <br /> Sow dispenser <br /> Cuuirap 9o�d sanibzer bxxat- <br /> Neach&water for <br /> Propane Stove Bleach <br /> storing mppng cloths <br /> Booth must be on <br /> Concrete.Asphalt, <br /> c»> r <br /> �.•" �r ..�F �a ..: ��1 Plywood,or a Tarp <br /> ap <br /> So and W.- Rinso W,3wr Bleach anViVator <br /> Garbage <br /> Can <br /> F7re F.V.-awsner, <br /> fxNa <br /> Water <br /> Ice Cooler 5 Gal 6andwash <br /> LAVa Ice Baps S Food Gowafners must to aslawater Corttalne' <br /> --------�+�-�- stamd 6,nch@S orrof the Drolmffi <br /> 1 <br /> EHD 16-C2 Page B of 11 TEMP EVENT APP <br /> 71MIS <br /> l <br /> f <br />