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�Y <br /> 10. 1 am providing the following hold temperature control for the cold holding of potentially hazardous foods below <br /> 45°F (if food is used the following day, maintain below 41 OF temperature): <br /> [91/ce chests ❑ Refrigerator <br /> ❑ Refrigerated truck Q4 bath and tubs <br /> ❑ Other(specify) <br /> 11. 1 am providing the following items within my booth for warewashing: <br /> ❑ Three 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 /> 12. ;Detergent, <br /> iding the following items within my booth for the sanitary cleaning of food preparation utensils: <br /> bleach, wi in cloths (cleaning towels), and a tub to store wiping cloths in bleach solution. <br /> wiping <br /> 13. 1 am providing the following for adequate hand washing facilities, but separate from utensil wash within my booth: <br /> [?(Water 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 /> 14. Names of res onsible persons to be present in booth during all hours of operation. <br /> "Impor ;.'* 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 /> 15. Completed by: <br /> Signature Title Date <br /> a . <br /> 5-20 Gal. <br /> Health Permit Ste Hand wash Water <br /> mo w/Chaffi ng <br /> Dish <br /> Paper Hand Towels <br /> Soap dispenser <br /> Cutting Board Sanitize,buoket- <br /> bleach&water for <br /> Propane Slove <br /> Bleach storing wiping cloths <br /> FBootmust be on <br /> h <br /> oncrete,Asphalt, <br /> lywood,or a Tarp. <br /> Propane Tank <br /> Soap and Water Rinse Water Bleach and Water Garbage <br /> Can <br /> Fire Extinguisher <br /> Extra <br /> Water <br /> ICe Cooler ''� i e�iG �'.3.4a'i9"4 �'d$iif�r 5 Gal Hand wash <br /> Extra Ice Bags 8 Food Containers must be Wastewater Container <br /> stored 6 inches off of the groundl <br /> EHD 16-02 Page 8 of 11 TEMP EVENT APP <br /> 7/14/15 <br />