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SAN 10 A Q U 1 N Environmental Health Department <br /> -� i� TY, <br /> vreotnes5 grows here <br /> 10. 1 am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br /> 457(if food is used the following day, maintain below 41 OF temperature): <br /> ❑ Ice chests ❑ Refrigerator <br /> ❑ Refrigerated 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 utensil <br /> TTThree 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 /> ❑ Detergent, bleach, and wiping cloths(cleaning towels). <br /> ❑ Tub to store wiping cloths in bleach solution. <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 /> ❑ One separate tub(bucket or basin)for the collection of nnsetwastewater. <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----Reorini—nW to festival coordinator three weeks Drior to <br /> this even <br /> 14. Completed by: <br /> gnature Tide ate <br /> 5-20 Gat. <br /> f Health Permit c- Hand wash Wager <br /> Stemo w/ChaKirg <br /> Drsh <br /> i Paper Eland Towels <br /> Snap dispenser <br /> Cngling Board ------ Sar0mar tw"- <br /> t I bleach 8 wate-h;r <br /> Propane Save 1 Bleach storing w prg_t lhs <br /> Booth must be on <br /> ! Concrete,Asphaa. <br /> Plywood or a Tarp <br /> Propane TaMc <br /> Soap and Water Rinse Water Bleach and Water Garbage <br /> Can <br /> Fire Extinguisher <br /> Eadra <br /> Weser <br /> Ice Cooler 5 Gal Hand wash <br /> f Extra Ice Bags 6 Food Containers mug be Wastewater Conlainer <br /> srored 6 NXIMS off of Me growl+ <br /> 4 OnO C u.,-.—If-- n....... l nr')nc I r nnn AnO oenn r c Inn Aar n4130 1 .......,,.--,.4 �._�. <br />