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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 /> ( Ice chests ❑ Refrigerator <br /> ❑ Refrigerated truck A Ice bath and tubs <br /> ❑ Other(specify) <br /> 11. 1 am providing the following items within my booth for warewashing: <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 /> 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 /> Water supply dispenser with warm 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 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 ooration: <br /> ri•� p� t-tu,ri��C) 44 teX �cth bay <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 /> 15. Completed by: OMfu,�, Llp <br /> Signature Title Date <br /> 5-20 Gal <br /> Health Permit Hand wash Water <br /> Sterno w/Chaffing <br /> Dist <br /> Paper Hand Towels <br /> Soap dispenser <br /> Curling BoarC Sambzer bucket- <br /> bleach 8 water for <br /> Procaoe Stove <br /> B;east storing wiping cloths <br /> Booth must be on <br /> OConcrete,Asphalt, <br /> Plywood,or a Tarp----------- . <br /> Propane Tank <br /> Soap and`,Vater Rmse Wats Bleach and Water <br /> Garbage <br /> Can <br /> Fire ExanGuisher <br /> Extra <br /> Water <br /> Ice Cooler 5 Gal Hand wase <br /> Extra Ice Bags 8 Food Containers must be Wastewater Centamer <br /> stored 6 inches off of the ground' <br /> EHD 16-02 Page 8 cf 11 TEMP EVENT APP <br /> 7/14/15 <br />