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1 <br /> armproviding the following cold temperature control for: the cold holding of potentially hazardous foods below <br /> 45`F(if food is used the following day,maintain below 41`F temperature): <br /> I ice chests ❑Refngemtor <br /> F1 Re`rioerated truck '�ce 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 /> Three compartment sink. <br /> CP, <br /> Three deep tubs (basins o-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br /> ScVton(one tablespoon of bleach per gallon of water) <br /> �D_tergent, bleach,and wiping cloths(cleaning towels) <br /> Test strips to measure sanitation levels for bleach solution, measuring 100ppm. <br /> KTub 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 10717(i.e. 5.20 gallon container with spigot). <br /> l One separate tub(bucket or basin)for the collection of nnselwastswater. <br /> -Paper towels and pump-style soap container. <br /> 13 Nam s of responst le persons to be present In booth during all hours of operation: <br /> "Important*" All food vendor booths are subject -.o irspection. Please make a cooy of this apa:icatior � <br /> preparation for this event. A, copy cf th:s c^eok::st must be in the booth at all t,o:trs <br /> oreparation and operation. Return original to festival coordinator three weeks prior to <br /> 'his event. <br /> 14, Completed by <br /> Title ate <br /> Health Permit i` (� art 'as6h,.ata <br /> t Steno w/GhY??; <br /> ^9 Board \ 5 <br /> aniE2x Lutb <br /> "ell <br /> / Eooth must be on <br /> - ^ Concrete.Asphalt <br /> `- Plymad.or a Tarp. <br /> ?rc:ture'a�k - <br /> Rnse'Fjater E Ea:+• <br /> Garbage <br /> Can <br /> =c-a <br /> Ice Cooler - - -- <br /> 5 CA--,ard w"n <br /> cxra;.e Saps i rwa ca ast_�nata; tai-•cr <br /> E`er tE-02 <br /> r ?aac 9 of 11 'Erv.?E'dE}•:'APP <br />