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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 41OF 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 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 /> Detergent, 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 /> -t' S AV-, Zj,-tr kO LA-CA e-- <br /> 14. 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. Return original to festival coordinator three weeks prior to <br /> this event. <br /> P <br /> 15. Completed by r ( t l� r,� Y' kl���1� { 10 a (c (S <br /> Signature 'Title Date <br /> 5-ZO Gal. <br /> Health Permit L Hand we&iWater <br /> ._.. StemewlCna`ting <br /> 7sh <br /> Paper Hsnd?caseis <br /> Soap dspsnse <br /> CiKt ng Boar t SarHzer huc at- <br /> b'seaCh&Ovate for <br /> B!eactt sia^ng wiping c3oths <br /> Prooa w Stove —�^ <br /> 3ooth muss be on <br /> -- � 04 Concreta,Asphalt, <br /> P,ywaod,or a Tarp. <br /> Propane?ark <br /> Soap end Naie; Rinse VVaze' S're31,V--ter , Garbage <br /> Can <br /> Fare Extingsisher <br /> f Ezt!a <br /> 1 -4vater <br /> i <br /> Ice Cooler : s ~ - 5 Gal Hand w <br /> r=xtra km Bags 8 Food CoWamrs must be 1Nastev+ater CoM <br /> stored 6 inches off of fie ground+ <br />