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a <br /> r. <br /> Y <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 <br /> ❑ Other(specify) <br /> 11. 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. I 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. Nam M0, <br /> siblam rsons 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 /> YI15. Completed by: I ' AAM� W �J 6 i� r 13 <br /> ' si 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 a <br /> Cutting Board Sanifizer bucket- <br /> bleach&water for <br /> Propane Stove Bleach <br /> storing wiping cloths <br /> Booth must be on <br /> Concrete,Asphalt, <br /> Propane Tank 00 r a Tarp. <br /> «-- -- �-- ---- —-..—�_ Plywood,o <br /> Soap and Water Rinse Water Bleach and Water <br /> Garbage <br /> Fire Extinguisher Can <br /> '` Extra <br /> Ice Cooler <br /> 5 Gal Hand wash <br /> Extra Ice Bags&Food Containers must be Wastewater Container <br /> — --- stored 6Inches offofthe ground/ . <br /> rtg� <br /> EHD 16-02 Page a of 11 TEMP EVENT APP <br /> 7/14/15 <br /> q <br /> e <br /> a <br />