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10. I am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br /> 450F (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. I am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br /> .�' hree 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 /> Isetergent, bleach, and wiping cloths (cleaning towels). <br /> -L31rub 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 /> One separate tub (bucket or basin)for the collection of rinse/wastewater. <br /> 'Z--p'aper towels and pump-style soap container. <br /> 13. Na iis of__response a persons to be pres rn booth dpring all ors of per-ation: <br /> In-E"11 e� 4"Ail. t-L�Y C vL4 <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 /> t ent. <br /> 14. Completed by: a" 5 li <br /> Signature Title Dbte <br /> 5-20 Gal. <br /> Health Permit Hand wash Water <br /> Stemo wlChaHing <br /> Dish <br /> _ Paper Hand Towels <br /> Soap dispenser <br /> Cutting Board SaniGzerbucket- <br /> htearh&walar Ior <br /> Propane Stove Bleach <br /> stonng wiping cloths <br /> Booth must be on <br /> Concrete,Asphalt, <br /> Plywood,or a Tarp. <br /> Soap and Water Rinse Water Bleach and Water Garbage <br /> Can <br /> Fire Fxting0sher <br /> Extra <br /> water <br /> Ice Cooler 5Gal Hand wash <br /> Extra fee Bags 8 Food Containers must be Wastewater Container <br /> stored E inches off or the ground! <br /> EHQ 16-02 Page 8 of 11 TEMP EVENT APP <br /> 08/01/16 <br />