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10. 1 am providing the following temperature control for the cold holding of po tlly hazardous foods below <br /> > 45`F(if food is used the fbi—oing day,maintain below 41°F temperature): <br /> ❑Ice chests [refrigerator <br /> [SKefrigerated truck ❑ Ice bath and tubs <br /> ❑Other(specify) <br /> 11. 1 am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br /> Rthree 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 /> (!]tletergent, bleach, and wiping cloths(cleaning towels). <br /> C►Test strips to measure sanitation levels for bleach solution measuring 100ppm. <br /> 0 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 /> P115ne 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 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: <br /> Signature Title Dat <br /> 5-20 Gal. <br /> 1 Health Permit Hand wssr Water <br /> �� stemo w/chatfing <br /> �Cish + l\\ <br /> aaWsr Hand Towels <br /> Soaa dispense \ <br /> Cutting Eoard \ <br /> 58ni$Zw tWCkel- <br /> Clea:�h&water for <br /> Propane Stave Bleach storing*Ping Goats <br /> Booth must be on <br /> Concrete,Asphalt, <br /> -- Plywood,or a Tarp. <br /> _ �- I I Soap ard`Natgr RinseYJa!sr B'ezvh and'1,1ater <br /> Garbage <br /> Can <br /> i 1 r're Extingtusher <br /> C)dr-y <br /> Water <br /> �i <br /> Ice Cooler l ' - _� ._:_..: <br /> .—�' S Gal Hand wash <br /> L__�p FiE-,-x. <br /> &Food Containers must be Wastewater Container <br /> olr of the gmurdl � <br /> EHD 16-02 Page a of 11 TEMP EVENT APP <br /> 1114114 <br />