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10 1 am providing the following cold temperature control for the cold holding of potentially hazardous foods beiovJ <br /> 45 F(if food is used the following day., maintain below 41°F temperature): <br /> ce chests [l Refrigerator <br /> Refrigerated truck ❑ ice bath and tubs <br /> Q Other(specify) <br /> 11. I am providing the following items within my booth for warewashing: <br /> ❑Three compartment sink. <br /> QR <br /> 10-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, i am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br /> IZADetergent, bleach,wiping cloths(cleaning towels), and a tub to store wiping cloths in bleach solution. <br /> 13. i 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 1017F (i.e. 5-20 gallon container with spigot). A <br /> ifiparate 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 /> ''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 /> preparqbafflain-d operation. Return original to feslt�vai coordinator three weeks prior to <br /> thi$ lent. <br /> 15. Complet <br /> Signature Title Date <br /> 9-20 Ga <br /> Health Permit HaIVwaShwat� <br /> SteM WtChaNrrg <br /> {3ssh <br /> gaper Hardd Ttswets <br /> SOW disperser <br /> cuffmg BOard San�tizer wcicet- <br /> niewn&wate.r.f for <br /> Prs}p3rie Stove Bleach stonng wiping ctOMS <br /> Booth must be on <br /> 0�} Concrete,Asphalt, <br /> , Plywood,or a Tarp, <br /> Arcane TF. <br /> snap and Wate? r2st a water aiea�and Wale, Garbage <br /> Can <br /> Fae Ext. sher <br /> ExNa <br /> Wadm <br /> II <br /> Ice Cooler 5 Ga Hard wash 4 <br /> wasiewater Corta+ner <br />