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s <br /> 10. 1 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 /> ❑ Ice chests ❑Refrigerator <br /> ❑ Refrigerated truck ❑ Ice bath and tubs <br /> ❑Other(specify) F� <br /> 11. 1 am providing the following items within my booth for warewashing: <br /> ❑OR K%Three compartment sink. r IV v t/V'�f2f-c, 1ASQD <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 /> ater supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). A <br /> >se&parate 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 /> --0-tnrA-- c an <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. � 0 b !�,, <br /> 15. Completed by: I J vv(� —7 <br /> Signature Title <br /> 5-20 Gal <br /> Health Permit Hand wash Water <br /> Stemo w/Chaffing <br /> Dish <br /> Paper Hand Towels <br /> Soap dispenser <br /> Cutting Board Sanitizerbucket- <br /> b!each&water for <br /> Propane Stove <br /> Bleach storing wiping Goths <br /> Booth must be on <br /> O Concrete,Asphalt, <br /> Plywood,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 � 5Gal Hand wash <br /> ! Extra Ice Bags&Food Containers must be Wastewater Container <br /> ---- ------ ---^' stored 6 inches off of the ground! <br />