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' 10. 1 am providing the following c 3mperature control for the cold holding of pote y hazardous foods below <br /> 457(if food is used the following day,maintain below 41'F temperature): <br /> ❑ Ice chests ❑ Refrigerator <br /> ❑Refrigerated truck [4-tCe bath and tubs <br /> ❑Other(specify) <br /> 11. 1 am providing the following items within my booth for the sanitary cleaning of food preparation utersils <br /> n l nree compartment sink. <br /> OR <br /> hree 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 /> 2'6etergent,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 cortainer with spigot). <br /> [9-bne separate tub(bucket or basin)for the collection of rinse/wastewater. <br /> [9'Paper towels and pump-style soao container. <br /> 13. Nam Efeponsible persons to be present in booth during 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: _1 C (D <br /> Signature Title Date <br /> __-.---.• <.,..,.:... -'d,l 5.20 Gal, <br /> Health Permit ;! Ha"d'n'a5rt',a'e' <br /> Sterno wtChatting <br /> D sh <br /> Papar Hand Towels <br /> Soa;dlsce�ser �1I <br /> cutting Z— I 5anitzerbucket- <br /> Neach d water for <br /> ProRane Stove 8leach storlrg wiping cloths <br /> Booth must be on <br /> Concrete,Asphalt, <br /> Plywood,or a Tarp. <br /> Propene Ta"kc '... - <br /> - I Scap and Water Rinse Water B".eat and Water Garbage <br /> Can <br /> Ezra <br /> V.'ater <br /> It / <br /> Ice Cooler ( '� - S Gat Hand wash <br /> 1 Ezrra ke Bags d Food containers must be Wastewater Container <br /> staei F Inches otr or the ground! <br /> EHD 16-02 Page 8 of 11 TEMP EVENT APP <br /> 1114114 <br />