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• I am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br /> 45aF(if food is used the following day, maintain below 41`F temperature). <br /> Ice chests Refrigerator <br /> ❑Refrigerated truck j!(Ice bath and tubs <br /> L]Other(specify) <br /> It. I 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 /> U 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 /> ❑Water 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 /> ❑ Paper towels and pump-style soap container. <br /> 13. Names of responsible persons to be present in booth during all hours of operation: <br /> ai?i'10 NCA117 <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. Retum original to festival coordinator three weeks prior to <br /> th is a ent. <br /> 14. Completed by: "h <br /> Signature Title (Dale <br /> 5-20 Gal <br /> Perm <br /> hand wash <br /> Health VYaler <br /> Ste rro vrChaffing <br /> Disci Paper FianO Towels <br /> Soap drsperrscr <br /> sarnezer bucket <br /> Cuttinp Board bleach S waler for <br /> s%ormg w+psq cloths <br /> Bleach <br /> Propane Stove <br /> Booth must be on <br /> O Concrete,Asphatl <br /> Plywood,or a Tarl <br /> propane Tants <br /> Sip and Waw Rune Water Bleach and Water Garbage <br /> Gan <br /> Fire ExpMnsher Extra <br /> W trier <br /> 5 Gal Hand wash <br /> Ice Cooler waslitomerContainer <br /> Ex"Ice Bags d Food Contaxrds must be <br /> stared 6 aches Off of the Wow'd! <br /> TEMP EVENT AP <br /> Page 8 of 11 <br /> Flff)16.02 <br />