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10. 1 am providing the following coca 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 track ❑ Ice bath and tubs <br /> ❑ Other(specify) <br /> 11. t 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 gumLsle soap container. <br /> 13. Names of responsible persons to be present in booth during all hours of operation: <br /> George Dale <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 /> Digitally,igned by George Dale <br /> DN:cn George Dale,o,ou, <br /> 14. Completed by: George Dale --i hssr,eyrlalekreeMlmairc° Owner 3/5/2018 <br /> Sign$BM.feH.03.0-01.11,40-09.00• Title Date <br /> 5-20 Gai <br /> Health Permit Sterno wlCHand wash Water <br /> ha�ng <br /> Dish <br /> Paper Hand Tenvvls <br /> Scrap dispenser <br /> Gutting[bard Sanitiser buckol- <br /> hleach&water for <br /> Propane Stove <br /> Bicap slpriny wipiny cloths <br /> Booth must be on <br /> Concrete,Asphalt, <br /> Plywood,or a Tarp. <br /> PruUanc Tenk �� <br /> Snap and Walcr Rknsc Walcr Blcad,and Waler Garbage <br /> Can <br /> Fire Exlinquishm <br /> Extra <br /> WaILY <br /> Ice Cooler 5Gal Hand wash <br /> Extra Ice Sags d Food C mi,ers must be Waslewaler i:onlainer <br /> staved 6 inches off of the groin± <br /> EHO 16-02 Page 8 of 11 TEMP EVENT APP <br /> 48102!16 <br />