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10. , 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 Ice bath and tubs <br /> (9 Other(specify) <br /> 11. I am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br /> ❑Three compartment sink. <br /> OR <br /> CZ 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(cloaning 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 /> l]Water supply dispenser with warm water at a minimum of 100°F(i.e. 5-20 gallon container with spigot), <br /> ane separate tub(bucket or basin)for the collection of rinse/wastewater. <br /> [g Paper towels and pump-stvie soap container. <br /> 13. Names of responsible persons to be present in booth during all hours of operation: <br /> t > ass--to�hQ > e .-, <br /> "Important'* Ail food vendor booths are subject to inspection. Ptease snake 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 /> 14. Completed by; <br /> Signature Title Dafe � <br /> 5-20 Gal, <br /> Health Per Hand wash wafer <br /> Slorno w1Cha11ing <br /> iJish <br /> Papa�,,rtl TewaEs <br /> Soao aispsrlser <br /> Culling Boerd Sanitizw 5uchat- <br /> bleach 8 nater for <br /> Propane Siwe 84each <br /> 5[0'ing wp}:n ccths <br /> Rooth must be on <br /> Concrete,Asphalt, <br /> Plywood,or a Tarp. <br /> Propane Tank <br /> Soap a.^c Waiar Rinse Waier Bleach and Water <br /> Garbage <br /> Can <br /> Fire Extinpulshar <br /> Extra <br /> Waver <br /> Ice Cooler 5 Gel Hand wash <br /> Erma Ice Bags&Food Containers musl be Waslewatalr Container <br /> slored 6 inches cif of the ground! <br /> EHe 16-02 Page B of 11 TEMP EVENT APP <br /> 0&101116 <br />