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10. 1 am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br /> 450F(if food is used the following day, maintain below 41 OF temperature): <br /> Ice chests ❑ Refrigerator <br /> ❑ Refrigerated truck Ice bath and tubs r <br /> �ther(specify) V (4 I rvyv <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_ 1 am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br /> �etergent, bleach, wiping cloths(cleaning towels), and a tub to store wiping cloths in bleach solution. <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 responsible persons to be present in booth during all hours of operation: <br /> Vs'o�- <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. Return original to festival coordinator three weeks prior to <br /> this a ent. I/ /1 <br /> 15. Completed by: :—, " , <br /> Signature Title a e <br /> I Y <br /> Health Permit E;4��] <br /> Stern w/Ghaffing <br /> Dish <br /> Paper Hand Towels <br /> Soap dispenser <br /> Cutting Board Sanitize'bucket- <br /> bleach&water for <br /> Propane Stove <br /> Bleach storing wiping Goths <br /> Booth must be on <br /> n Concrete,Asphalt, <br /> IVI Plywood,or a Tarp------------ <br /> Propane Tank <br /> i Soap and Water Rinse Water Bleach and Water Garbage <br /> &< Can <br /> Fire Extinguisher <br /> �" Water <br /> y <br /> CiP+ COOS@(' I �'..'iq-,.:� z: ,?r'. th` :' 'F tr :, 5 Gal Hand wash <br /> g Extra Ice Bags&Food Containers must be Wastewater Container <br /> stomd B Mches off of the ground' <br /> EHD 16-02 Page 8 of 11 TEMP EVENT APP <br /> 7/14/15 <br />