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i <br /> 10 1 am p oviding the following cold temperature control for the cold noding of potentialy ha-zardous foods belc:a <br /> 45`F(if food is used ti,e following day, maintain below 41'F temperature): <br /> Ice chests ❑Refngerator <br /> Refrigerated truck Ice Seth and tubs <br /> Other(specify) <br /> 11. 1 am providing the following items within my booth for the sanitary cleaning Wood preparation uten,sft. <br /> OR [Three compartment sink <br /> Three deep tubs (basins 5-8 inches mirimum), one for soapy %,rater, one fo, rinsing and one for a bleach <br /> Clution(one tablespocn of bleach per gallon of water" <br /> (Detergent, blew 3-d wiping cloths(cleaning towels,. <br /> C)4est strips to measure sanitation !evels for bleach solution measuring 100ppm. <br /> Tub to store wiping cloths in bleach solution measuring 100ppm. <br /> 12. i amrroG�iding the following <br /> booth- for adequate hand wash!na facl;rie3 but sepe-ate from utensil was^ within my <br /> ot <br /> vwater supply dispenser jvfth warm water at a minimum of 1037 6.e. 3-20 gallons container with spigot). <br /> Q'e separate tub(bucket or bas'.^.t for the collection cf r!nSE/V.aSt�::'aiEr. <br /> Paper tov:els and oumG-style sgao container, <br /> 13 Na^es of re pons!ble persons to be present in booth during al! hours of operation,. <br /> "Important`* All food vendor booths are subject to inspection. Please make a copy of this application <br /> preparation for :his event. A copy of this ChEck!:st .lust of in the booth at all hours o; <br /> prepay 'ion and operation. Return original to festival coordinator three weeks prior to <br /> this ve t. <br /> completed by: �'�, S� <br /> Signature Title Date <br /> Health Parm <br /> Stsr,�N- ra'h�� I <br /> C;Rt-g Bond '\ <br /> aariizabxa<s- <br /> �'etto"M 8+r6tV for <br /> itwn%-m N,;aOhi <br /> i BOOM r'{U$t be 0^ <br /> r Concrete,Asphalt. <br /> 1 0 I� <br /> rc� - Ptyv ood or a Tarp. <br /> ie-otic ( - <br /> - J ' Snap and t4 Ra aW ce Y nd'.1 <br /> iater a fia-am 1 <br /> Garb,, <br /> _ee <br /> t C4 <br /> d:are< <br /> L <br /> f - ` <br /> ICE CGOt@C SGoKa.^aaasr t <br /> ae, :e Gap$S P,.=C*�tsne.K r.vv Mrgwatof Cxta near <br /> Yatfrst,rnc"esoro."'.6P"ueX <br /> Ertt7 te-02 <br /> Pew 8 of 11 'Erg:?E1'cr.*;,cP <br />