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I <br /> 10. 1 am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br /> 45eF(if food is used the following day,maintain below 41 eF temperature): <br /> I <br /> ❑Ice chests .S Refrigerator <br /> ❑ Refrigerated truck ❑ Ice bath and tubs <br /> ❑Other(specify) <br /> r <br /> 11. 1 am providing the following items within my booth for the sanitary cleaning of food preparation utensils: I <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 /> i <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 /> Sail Li,a,ieZ <br /> i <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: C�Q'LA� aqLksz Qw AP-V 0 19 <br /> Signature Title Date <br /> ' a-za cnl. <br /> Health Permi� Hand wash Wafer <br /> Sterno wlChelf n9 <br /> Dish Paper Hand Towele <br /> Soap dispenser i <br /> Culling Board 3enitiier bucket- f <br /> bleach 8 water Inr <br /> Propane Stove <br /> Bleach ahminp vdpfng dolha 1 <br /> Booth must be on <br /> Concrete.Asphalt, <br /> Plywood,or a Tarp. <br /> Propene Tenk <br /> Soap end Wnler Rinne Wale+ 61 eaG�end Weler Garbage <br /> Can <br /> Fire Extinguish.1 <br /> Ert+a <br /> Wetor <br /> �1 <br /> Ice Cooler J - - eGa,Hand wash <br /> Exlre Ice Bage d Food Conte/nora must rw Wealewa101 Container <br /> —V .rorwl 6 hcAca o!!of f!w ground! <br /> EHD 16-02 Page B of 11 TEMP EVENT APP i <br /> 08!01/18 <br /> i <br />