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10. I am providing 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 />11. <br />OR <br />14. <br />“Important*4 <br />I <br />Completed by:15. <br />Signature <br />•• <br />Paper Hand Towels <br />Soap dispenser <br />Culling Board <br />Bleach <br />Propane Stove <br />it <br />Bleach and WalerRinse Waler <br />Fire Exlinairtsher <br />Ice Cooler <br />sloiod S Inches off of the ground! <br />TEMP EVENT APPPago a of 11 <br />I <br />I <br />EHD 16-02 <br />7/14/15 <br />□ Ice chests <br />□ Refrigerated truck <br />□ Other (specify), <br />5 Gal Hand wash <br />Wastewater Container <br />Sanitizer bucket­ <br />bleach & waler for <br />storing wiping dolhs <br />Booth must bs on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />Refrigerator <br />□ Ice bath and tubs <br />Extra <br />Waler <br />5-20 Gal. <br />Hand wash Water <br />Exira Ice flags & Food Containers must be ’• <br />stored 6 Inches off of the ground! i <br />Title <br />3 <br />Soap and Waler <br />Health Permit <br />Propane Tank <br />,5-e-/7 <br />Date <br />I am providing the following items within my booth for warewashing: <br />yf. Three compartment sink. <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 />12. I am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br />Detergent, bleach, wiping cloths (cleaning towels), and a tub to store wiping cloths in bleach solution. <br />Names of responsible oersons to be present in booth during all hours of operation. <br />__________________________________—------------------------ <br />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 festivai coordinator three weeks prior.to <br />this event. <br />|C~ ~ , <br />Garbage <br />Can <br />13. lam providing the following for adequate hand washing facilities, but separate from utensil wash within my booth: <br />OWater supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). A <br />separate tub (bucket or basin) for the collection of rinse/wastewater. Paper towels and a pump-style soap <br />container. <br />ilafnowAOWrino