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10. 1 am providing the following cold temperature control for the cold 'holding of potentially hazardous foods beic,v <br /> e4YF(if food is used the following day,maintain below 41`F temperature): <br /> ice chests ❑Refngera'or <br /> El Refrigerated truck ❑ Ice bath and'ubs <br /> Other(specify). <br /> 1 1 am providing the following items within my booth`or the sanitary cleaning of food prepa at,on t tensils: <br /> IX Three compartment sink <br /> OR <br /> Three deep tubs (basins 6-8 inches minimum), one for soapy water, one fo: 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 from utensil wash within my <br /> booth: <br /> �X vva-er supply disperser:with warm water at a minimum of 100Q17(i.e. 5-20 gallon container with spigot). <br /> X O-e separate tub(bucket or bas in,for the coilectior of nnsebAsstewater. <br /> Paper tovvels and pump-stye soao container. <br /> 13 Narnes of responsible persons'o be c•esent in <br /> "Important" All food ve^der bon-'-= are subject - s:,ection. Please maize a copy of this applicatic- - <br /> preparation for this _:tent. P, copy -.'-is check"st n;s' be in tie booth at al c_r <br /> preparation and operation. Return original to festival coordinator three weeks prior to <br /> this event. <br /> 14. Completed by: a --- 6+ <br /> Sign`!i�,ra Title Date <br /> Health Permit �� ; an xssre'a;e• <br /> Stena rrrCt+a1�3 <br /> 177 <br /> �1G^g 8pa9 <br /> Sari129!txke:- I <br /> d wale'for l <br /> :��ro Slaps � g._-; •� I s;:nr�Ma'�gets <br /> �J\� <br /> Eoot`must be o <br /> 0 <br /> / Concrete,Asp*aft <br /> J i -.0- i -- Plywood or a Tarp. <br /> fCa?J12�c';k <br /> Sam�a:':':I<� 4nse YJaier 2fa:!•71:�:'1st!' <br /> Garbage <br /> ire Es!7 <br /> Car: <br /> :xra I <br /> Ice Cca(er ' f <br /> 5 G+� dandy uas^ <br /> E tine ice saps A Fa-,o Ca+tur.�rs nus!Ds t:as:.r aicr�Cr,GYaW I <br /> - —- Sfamd 6 4ac4e5 era: <br /> c`=; T£hl.?EVEN,APP <br />