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10. 1 am providing the following c :mperature control for the cold holding of pote y hazardous foods below <br /> " 45`F(if food is used the follow,,ig day,maintain below 41'F temperature): <br /> ❑Ice chests ❑Refrigerator <br /> ❑Refrigerated truck ❑Ice bath and tubs <br /> ❑Other(specify) <br /> 11. 1 am providing the following items within my booth forthe 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 from utensil wash within my <br /> booth: <br /> ❑Water supply dispenser with warm water at a minimum of 100`F(i.e. 5-20 gallon container with spigot). <br /> ❑One separate tub(bucket or basin)for the collection of rinse/wastewater. <br /> ❑Paper towels and pump-style soap container. <br /> 13. Names of responsible persons to be ent in booth during all hours of operation: <br /> fNlrGt✓Lg,L-e�lil 1�u�1— <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. I A P , 10 1 a J b <br /> Signature Title Date <br /> z., <br /> � <br /> 5.20 Gal. <br /> stemow1chatSng Hand Permit ' `1 He wash Water I <br /> 0!sn i <br /> Paper Hand Towels <br /> Sot^,dspanser <br /> Cutting;Curd SaMtZer Cucket- <br /> Nean 6 water'or <br /> Pra;.ane Stove eEzcr storing wiping cloths <br /> Booth must be on <br /> Concrete,Asphalt, <br /> L11 <br /> Plywood,or a Tarp. <br /> Soap and V^Nat Rinse'ddaler 8!ea�and�",pater <br /> Garbage <br /> Can <br /> F'va cxtingtusher <br /> e#ra <br /> Water <br /> /i <br /> �--- <br /> i .. 5 Gal Hand Wash <br /> ��I= Extra ice Bags 6 Food Containers must he Waziowatar Container <br /> stored 5lnches oRor the gaud( <br /> EHD 16.02 �[, <br /> 1114114 Page 8 of 11 TEhkP EVENT APP <br />