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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 /> ❑ lee chests ❑Refrigerator <br /> ❑ Refrigerated truck ❑ Ice bath and tubs <br /> ❑ Other(specify) <br /> f��V A- <br /> ll. I 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. 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 rinse/wastewater. Paper towels and a pump-style soap <br /> container. <br /> 14. Names of responsible person§_tQ,be present in booth during all hours of operation: <br /> I' CCAAAA 1n VN GMCA� <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: �� _ � � . 3` V <br /> Si nature Title Date <br /> 5-20 Gal. <br /> Health Permit Hand wash Water <br /> Stemo w/Chaffing <br /> Dish 1 <br /> Paper Hand Towels <br /> Soap dispenser <br /> E <br /> Cutting Board Sanitizer bucket- <br /> bleach&water for <br /> Prcpane Stove Bleach storing wiping cloths <br /> Booth must be on <br /> Concrete,Asphalt, <br /> Plywood,or a Tarp. <br /> Soap and Water Rinse Water Bleach and Water <br /> Garbage <br /> Fire Extinguisher Can <br /> F�dra <br /> Water <br /> Ice Cooler stored raun g <br /> 5 Gal Hand wash <br /> - a Ice Bags&Food Containers must be Wastewater Container g_ <br /> ............... ___._ 0 9 dl R <br /> EHD 18-02 Page 8 of 1i TEMP EVENT APP <br /> 7/14/15 <br /> i <br />