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10 I an, providing the following cold temperature contrc; for the cold holding of poi., Jally hazardous foods belo', <br /> 15`17;'f food is used the following day,rra;ntain below 41°F temperature): <br /> ❑ Ice chests ❑ Refrigerator <br /> ❑Refrigerated truck ❑Ice bath and tubs <br /> lJ Other(specify) <br /> 11. 1 am providing the following items with:n my booth for the san tary cleaning of food preparation utensils: <br /> ❑Three compartment sink <br /> rJ R <br /> ❑ Three deep tubs (basins 5-8 inches minimuml, one for soapy water, one for rinsing and one fir a bleach <br /> sclition (one tablespoon of bleach per gallon of water) <br /> ❑ Detergent, bleach. and wiping cloths(cleaning towe,s . <br /> Test strips to measure sanitation levels for bleach solution measuring 100ppm. <br /> ❑Tub to store wiping cloths in bleach solution measuring 100ppm. <br /> 2. I am providing the following for adequate hand washing fac kties but separate from utensil wash 4vithin my' <br /> booth: <br /> ❑Water supply dispenser with warm water at a minimum of.00'F(i.e. 5-20 gallon container with spigot), <br /> L7 One separate tub(bucket or basin)for the collection of r;nsei:vastewater. <br /> ❑Paper towels and pump-s`y'e soap container. <br /> 13 Names of resppn•ible persons to be present i+koo�uriin al!hours of operation: <br /> it CP�Yn � A—) 't . /l <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 check::st must be in the booth at all hours of <br /> orreparation and operation. Return original to festival coordinator three weeks prior to <br /> 'his ,l'Crrt. Z1 <br /> 4. Completed by: <br /> Signature Title Date <br /> � 5-2D gal <br /> '-- I Fanc•assh Health Permit <br /> -are:hand%wA t <br /> SOG.7spev3r \ <br /> \ EffEl <br /> PM.ane 5'Ova <br /> Eoct7 must be on <br /> r :,c^c�ete.Asp!-sit <br /> plywood or a Tarp <br /> .. Soap zr.d Nalor Rrnse'J+ater f E'eao, ^;32er Garbage <br /> Car, <br /> Fire=xJ,2u.sner _,/I <br /> dieter <br /> ice C.00l81 <br /> Ex"r_e Bros 6 Fza f onruren r-:,rs!be <br /> EEC tE-C2 <br /> Par_9 of 1 t "EF.'?E'E"-; •:P <br />