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A <br />to. <br />11 <br />OR <br />13. <br />"Important** <br />Health Pwrn»■i <br />Scup dHpwiMr <br />CuttinqBo** <br />PnyamSlm BtoKh ' <br />5- <br />Rinse WaterSoap and Water Bleach and Water <br />Fira ExtingJaher <br />lee Cooler <br />Page 8 of 11 TEMP EVENT APP <br />>' <br />EHD 16-02 <br />08/01/16 <br />□ Refrigerator <br />□ Ice bath and tubs <br />Extra <br />Water <br />S Gat Hand wM <br />Wastewater Container <br />3/27/2021 <br />Date 'TWe <br />5-20 Gal. <br />r- Handwash Waiv <br />■ . \ <br />Paper Hand Tow*l* <br />.. JdlWRa®pBaaiW|aaBpBa|a| <br />Extra lea Sags & Food ConiUnerB must bo I <br />stored Sarc/ies off t/ftbognund' ■ <br />• 1» /‘ ■'- <br />F <br />12- <br />0 Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot), <br />done separate tub (bucket or basin) for the collection of rinse/wastewater. <br />dPaper towels and pump-styie soap container <br />Names of responsible persons to be <br />| Prapana Tar* <br />N^hnCheS l^r,imum^ 006 for 503Py water one for rinsing and one for a Kwh <br />Owergent. Weech, and wiping cloths (cleaning towels). <br />□ Tub to store wiping cloths tn bleach solution. <br />I^am^providing toe foltowing for adequate hand washing facilities, but separate from utensil wash within my <br />l am providing toe following cold temperature control for toe cold holding of potentially hazardous foods below <br />45’F (if food is used the foltowing day, maintain below 41 °F temperature): <br />□ Ice chests <br />□ Refrigerated truck <br />□ Other (specify) <br />’ <•• • . - • ■: - <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensils' <br />O Three compartment sink. <br />7^ • <br />Garbage <br />Can <br />Sanitaw budat- <br />Urach&Mtarfar <br />•tonnowtotooctad* <br />Booth mu«b»an <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />--------------------------------------------> ■■/'■< /. < <br />L ■ ■ ■ <br />bte persons to be present in booth during all hours of operation: <br />haA &i/Mfti _____________________ <br />All food vendor booths are subject to inspection Please make a copy of this application to <br />preparation for this event A copy of this checklist must be in the booth at an hours of <br />and operation. Return otfainai to frsthrai coordinator tone weeks prior io <br />t 14. Completed by: /SoltS <br />: ./■ ; signature <br />I :>r SternowfCfalfina <br />Oto .