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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 417 temperature): <br /> E2 Ice chests ❑ Refrigerator <br /> ❑ Refrigerated truck ❑ Ice bath and tubs <br /> ❑ Other(specify) <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 /> 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 /> Nimle d Jaime paygoza <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 /> 14. Completed by: Nrcoie Mnnre r.yU0s 3,252J,8 <br /> Signature Title Date <br /> 5-2a Gal <br /> Health Permit 0 Hand wash Water <br /> Sterno wlChaffing <br /> Dish <br /> Paper Hand Towels <br /> Soap tlispenser <br /> Cumng Board Sanitizer bucket- <br /> bleach&water for <br /> Propane St+}ve <br /> Bleach sionng wiping doths <br /> Booth must be on <br /> 0 Concrete,Asphalt, <br /> Plywood,or a Tarp. <br /> Propene Tank <br /> Soap and Water Rinse Waler Bleach and Water Garbage <br /> Can <br /> Fire 6ctinguisner <br /> Extra <br /> Nater <br /> FIceCooler 5 Gai Hand'Nash <br /> Fx1ra Ice Bags 8 Food Containers must be Wastewater Container <br /> s1cred 6 inches off of the ground! <br /> EHD 16-02 Page 6 of 11 TEMP EVENT APP <br /> 08101116 <br />