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F <br /> i; <br /> d <br /> t <br /> 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 l <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. l 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 /> r <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 rinse/wastewater. Paper towels and a pump-style soap <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. r <br /> 15. Completed by: V�1 1 tl t 1 �'��' �U <br /> nature Title Date <br /> 5-20 Gal. <br /> Health Permit Hand wash Water <br /> Stemo w/Chaffing <br /> Dish <br /> Paper Hand Towels � <br /> Soap dispenser <br /> Cutting Board Sanitizer bucket- <br /> bleach&waterfor <br /> Propane Stove Bleach <br /> storing wiping cloths <br /> Booth must be on <br /> Concrete,Asphalt, <br /> Plywood,or a Tarp. <br /> PmpaneTank - - _. _ v..�.�.. _._�_�..._..—. _-� n c <br /> Soap and Water Rinse Water Bleach and Water Garbage <br /> Fire Extinguisher Can L <br /> = Extra <br /> Ice Cooler 5Gal Hand wash <br /> -_= Extra Ice Bags&Food Containers must he Wastewater Container p <br /> ---- ----------------- stored 6 inches offof the ground) . <br /> I< <br /> E <br /> EHD 16-02 Page 8 of 11 TEMP EVENT APP <br /> 7/14115 <br /> a <br />