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I I am providing the following cc'd tzmper._;.ure ccr.tr;l for flhe cold holding of pctentia.ly ha_ardc- s .gods belcvv <br /> 457;if fcod is used the fol g day:ma`ntain below 41'F temperature): <br /> ct Ice chests ❑ Refrigerator <br /> F]Refrigerated !ce oath and ;ibs <br /> 1. Other(specify) _ -- --- <br /> 'i. I am pr ov' ;ng the follo;ving items within my booth°.D.r tie san.-airy cleaning of food preparation utensiis <br /> Three cor. car rnent sin>• <br /> ] Three deep to s (basins 3 or-e for soapy water, one for r;nsi,ia a,-id one for a cD each <br /> soli'.icn;cra:at:lespocn of bfeac7 Der.aLon of vvate-n <br /> Detergent, cleat". and ..ip ng cicths!cleaning tones: <br /> Test str:os to measure s27itation !eve!s for bleact' solution measuring 'OOapm. <br /> [] Tub to store wiping cicths in bleat" solution measuring 15C:;pm <br /> i I am :rovidr'tg the following for adectuple hand was`ing fac a'ies. but st!pa-a'te ifon-, ute'is l 1"cis! 'vvit`lin ."y <br /> booth <br /> Wa`er supply dispenser with Lvarm water at a-A mum of'3�17 ::i.e. 5-20 gallon cortainer with spilt:t) <br /> One separate tub i,bUcKe:er ba=, =or the colle::tior, o°nnse! .,astsv.,ater- <br /> E Paper to:vats and puma-s`v e scat ccrtarer <br /> 13 Names of responsible pa•sccs to be p•esent in booth dur ng allho_: = r."cperatio^: <br /> "Important" AI food ve^dor boot^s are subject to inspection. Plcz-ce make a copy -f t7is aa;D'i:ai;-,7 in <br /> prepa'a:lon `ur '-is event, p. CDpy cf 'his cne,, .:- 7r N-: be in t!'ie booth at a ' --.1rs of <br /> preparation and operation. Return original to festival coordinator three weeks prior to <br /> this event. <br /> completed by: el °- Ct.4 n <br /> Signature Title Date <br /> r-- S.JJ_:30 <br /> Health P�rrnr ans.vs+t t:'aie <br /> I it E:OOI"MU Y.p <br /> i <br /> '•1 i I f _..r-._..=.J i ?i�sr'�i::.:-.{ i `�2.,,y'+a..�;2r r ,:�f�3�]C <br /> l! ( mar <br /> ( lice Cooler C:a A']:a5, <br /> —.-_--�-'_'-'-`-- - � _a;•e eBn-s:FJ;c i;o^tag:.ens cry:Cs �- :,']5._v:,:.�__r.:xncr � � _1_ <br />