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410, 1 am providing the following c emperature control for the cold holding of po, ally hazardous foods below <br /> 45eF(if food is used the following day, maintain below 41°F temperature): <br /> Ice chests ❑Refrigerator <br /> Refrigerated truck ❑Ice bath and tubs <br /> [I'Other(specify) <br /> 11. 1 am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <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 /> Detergent, bleach, and wiping cloths(cleaning towels). <br /> Test strips to measure sanitation levels for bleach solution measuring 100ppm. <br /> Tub to store wiping cloths in bleach solution measuring 100ppm. <br /> 12. 1 am providing the following for adequate hand washing facilities, but separate frorn utensil wash within my <br /> booth: <br /> Water supply dispenser with warm water at a minimum of 1007(i.e. 5-20 gallon container with spigot). <br /> (�One separate tub(bucket or basin)for the collection of rinselwastewater. <br /> (�Papertowels and pump-style soap container. <br /> 13. Names of r �s�po�nsib�l�e�perfons to be es�oth%iuring 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 /> 14. Completed by: <br /> Signature Title 6ate <br /> w, 5.21)Gal. <br /> Health Permit =1 Hand washWaler <br /> Steno wfChatfing <br /> Dish ! Paper Hand Towels <br /> Saaa dSFe'75ef <br /> Cutting Board Sarilizer bucks;- <br /> bleach&water for <br /> Prapane S:ova Bleach storing wiping cloths <br /> _ Booth must be on <br /> Concrete,Asphalt, <br /> —` --- " - -- Plywood,or a Tarp. <br /> - - I I crap ar;9 ti^.';ler RinseVuater Bleach and Water Garbage <br /> Can <br /> moire 5xtinguimor <br /> -extra <br /> Water <br /> Ice Cooler <br /> at lqar.d wash <br /> 1 : v.r a ice Bags 8 Fo,:d Containers rust be Waslowater Canlatnar <br /> -- ---� Sta.'t:dGfnchesoffafthegrourd+ <br /> END 1C-02 Paae 8 of 11 TEMP EVENT APP <br /> 1114114 <br />