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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 /> dice Ice chests ❑ Refrigerator <br /> ❑ Refrigerated truck rl ❑ Ice bath and tubs <br /> (Other(specify) CbtQs� _r f P fyQ <br /> 11. 1 am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <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 /> [Detergent, bleach, and wiping cloths(cleaning towels)_ <br /> ( Tub to store wiping cloths in bleach solution. <br /> 12. 1 am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br /> booth: <br /> C4 ter supply dispenser with warm water at a minimum of 100°F (i.e.5-20 gallon container with spigot). <br /> One separate tub(bucket or basin)for the collection of rinse/wastewater, <br /> stpaper towels and pump-style soap container. <br /> 13. 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 /> I <br /> 14_ Completed by: tZ ' CG �i�p,Q� `i 1-7 <br /> Signature Title Datb <br /> 5.20 cat. <br /> Health Permit Hand wash water <br /> Stcmo w/Chatfirg <br /> Dish Paper Hand TOHeIs <br /> Soap dispenser <br /> 0.ittinp Bond Sanitizer bucket- <br /> bleach 8 Nater for <br /> Propene Stova <br /> Bteac�+ smring xiping clouts <br /> Booth must be on <br /> Concrete,Asphalt, <br /> Plywood,or a Tarp. <br /> Soap and Water Rinse water Bleach and Water Garbage <br /> Can <br /> °M''. Fire Extinguisher <br /> i <br /> fC� Gooier i-;: SGal Hand wash <br /> t>-� Ex"Ica Bags&Food Cantainers mustbe Wastewater Container <br /> ----------- -----� stored 6 inches oAof the gro1md! <br /> EHD 16-02 Page 8 of 11 TEMP EVENT APP <br /> 08!01116 <br />