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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 /> 45°F (if food is used the following day, maintain below 417 temperature): <br /> I <br /> ❑ 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 /> 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). i <br /> ❑ Detergent, bleach, and wiping cloths(cleaning towels). <br /> I <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 I <br /> booth; <br /> ®Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). E <br /> ❑ One separate tub (bucket or basin)for the collection of rinse/wastewater. i <br /> ]KI Paper towels and pump-style soap container. <br /> 13. Names of responsible persons to he preent(n bgpth during all hours of operation: <br /> leve a we <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. j <br /> i <br /> 14. completed by: Owner 2/18/2019 <br /> t <br /> Signature Title Date <br /> .. ,... r. <br /> 5-20 Gal. <br /> Health Permit HandwashWater <br /> Sterno wlchaPong <br /> Dish <br /> Paper Hand Towels <br /> Soap dispenser <br /> Cutting Board Sanitizer bucket- <br /> bleach&water for <br /> Propane Stove <br /> Bleach storing wiping Goths i <br /> Booth must be on <br /> —• <br /> Concrete,Asphalt, <br /> Plywood,or a Tarp. <br /> Propane Tank . .;:..::... .. '>': ......... <br /> Soap and Water Wnee Wafer Bleach and Water Garbage <br /> Can <br /> Fire Extinguisher <br /> Extra <br /> Water <br /> l <br /> ,s a <br /> w <br /> ric--- <br /> Q CQQlQr """ _ S Gal Hand wash <br /> Extra Ice Bags d Food Ccnteiners must be <br /> Wastewater Container <br /> ..._.._._.__............. stared 6 inches olfollite ground! °- <br /> I <br /> EHO 16-02 Page 8 of 11 TEMP EVENT APP <br /> 08101116 <br />