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11.. I:a►t►providing t1l>e.fbIl6wing cold temperature control for the cold holding of potentially hazardous foods below <br /> 45"F:(if food is used the foilowing day,maintain below 41 OF temperature): <br /> Q ice chests Q Refigerator <br /> Q Refrigerated Rick 0 fee bath and-bibs <br /> Other(specify) <br /> 11 I am proved ngthe following items-Within my booth for Watewashing <br /> Q Three compartment sink.. <br /> OR <br /> j Q Three deep tubs (basins.6-8 inches minimum), one for soapy water;one for rims and'one fora bleach <br /> solution(one tablespoon of bleach.per gallon of water). <br /> ' 12. I:am.. . .: <br /> provrdirx, :the fdllowing items within my booth for the sanitary cleaarr+h9 of food preparation utensils <br /> Q Detergent;bleach,wiping cloths(cleaning towels), and a tub to store wiping cloths in bleach solution. <br /> 1:1 lath providing the following for adequate hand washing facilities,but separate from utensil wash within my booth <br /> Q Water supply dispenser with v wvn 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 rinselwastewater: Paper towels and a puma-style soaav <br /> container. <br /> 14. Names of responsible persons to be.presenfin booth:during all hours of operation: <br /> n <br /> �. Liz 54 .-1 o t <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 ail hours of <br /> preparation and operation. Return orio€nat to iestivlat coordinator three weeks Odor to <br /> this event. <br /> 15 Completed by: .:. 54 1rs 'er _ (� - �� <br /> a <br /> Signature Title Date <br /> �, Watar <br /> Health Permit Bend wash^ s�wire <br /> r�ri�xt7owalti .. <br /> aaav c�sirenar.: _ . <br /> r.,ur era sarttaa.txidee. <br /> bleAch 8 water for <br /> P+ a StakV Sh staling wrp�g I00l s <br /> Bootie must be on <br /> :Conemr - <br /> e,Awhalt, <br /> 7T Ptywood,or a Tarp: <br /> o +e TO* - <br /> Soap-dw6w Garbage <br /> Can <br /> r:Ye�i+�t+guis <br /> 6ArciA. <br /> 106 CoolerEx"�. sr ►ana« , <br /> ke <br /> e o r.« waste"er c <br /> ., ,.= stn+ad B irrr�is cr►dr dw gr+aiiwd! <br />