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10, 1 am providing the following cold temperature oontrol for the cold holding of potentially hazardous foods below <br /> 45117(if food is used the fallowing day, maintain below 41"f=temperatura); <br /> ❑Ice chaste Refrigerator <br /> ❑Refrigerated truck ❑ Ica bath and tubs <br /> 0 Other(speGry) <br /> 11, 1,am providing the fo0owing Name within my booth for warewashing' <br /> LACfnr'ee impartment 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 Leaning of food preparation utensils: <br /> Bt-e-t-e—rgent,bleach,wiping cloths(cleaning towels),and a tub to store wiping clothe if)g solution. <br /> 13, 1 a_.m, pr�oviiding the following for adequtrte hand washing feoilibes,but separate from utensil wash within my booth_ <br /> E-'' tBr supply dispenser with warm water at a minimum of 100T (Le, 5-20 gallon container w4h spigot). A <br /> separate tub (bucket or basin) for the collection of rinselwaatowater. Paper towels and e <br /> container. <br /> 14. IN17i of ponstb coons to be pre nt in during all hours of operation <br /> "Important" All food vendor booths are subject to €nspectlon. Please make a copy of this application in <br /> prepanitt4n for this event A Copy of this checklist must be in the booth et all hours of <br /> preparation and operation. Hatum_ortainel to hstivalrgRWlnabor three treell8-grlor to <br /> th%eye& <br /> M Completed by: <br /> Slgntrturs 'f s Date <br /> Health Permit MWW+Wh W&W <br /> orn <br /> Paper r+Wa TUMM <br /> soq,dlawnaor <br /> �some servtaar lxdere- <br /> Nesd,swM.lor <br /> upon Saw ElMem ��Mpro aaln" <br /> BoW musi be on <br /> Concretes.Asphalt <br /> Plyvuood,or a Tory. <br /> Prvpaee r�k <br /> �erdWetar ramsewetr �wrn.iaweror Garbage <br /> Gen <br /> '�" FYe ExtlryWRer <br /> f�Y W"fr <br /> Ice Cooler ' aGW„Hold*Ush <br /> hue roe 6.pr d roou OW&Mara MW ne wsra..Mrcrosw.� <br /> abyvoa"ro'ye g7dMe piOWd <br /> EHD 10-02 page a of 19 'rPW EVENT APP <br /> 7/14118 <br />