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10. I-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, malnialn below 41 aF temperature): <br /> Ice chests ❑ Refrigerator <br /> ❑ Refrigerated truok ❑ Ice bath and tubs <br /> ❑Other(specify) <br /> 11. 1 am providing the following Items within my booth for the sanitary oleaning of food preparation utensils: <br /> K Three compartment sink. <br /> OR <br /> ❑ Three deep tubs (basins 6-8 inohes 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, andwlping 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 utenslf wash within my <br /> booth: <br /> V9 Water supply dispenser with warm water at a minimum of 10017(Le, 5-20 gallon container with spigot), <br /> Q One separate tub(bucket or basin) for the collection of rinselwastewatel', <br /> Paper towels and pump-style soap container. <br /> 13, names of responsible persons to be pre e t In booth durin all hours of operation: <br /> � - fir- �-� L <br /> "klmportant" All food vendor booths are subjeot to inspection, Please make a copy of this application In <br /> preparation for this event A copy of this oheoklist must be in tho booth at all hours of <br /> preparation and operation, Return orlainal to festivol poordInator three weeks Prior to <br /> his event. <br /> `14. Completed by: v4� �� �L��r�ytr� 5/9124 <br /> S9 nature Title Date <br /> 6•20 Gal, j <br /> Health Permit Hendwash Wale <br /> filarno w1ChalMp <br /> Dish Papar Hand T owe;s <br /> fioepdispenstr ` 1` <br /> Culling Doard Sanikar bucket" ' <br /> Weadr s water for <br /> Propane Slove Bleadi etoAng vAp)N cloths <br /> Booth must be on 1 <br /> Generate,Asphalt, <br /> Plywood,ar a Tarp, ! <br /> AfooaReTank �]`�1 i <br /> ;;a. :�i:' �'�.,--•�a:,'1. r;�1_ r:.'.+' t. ..a,.';. %G.a a':S.d %5.?.�:I" 'T�:;Ity; <br /> q Soap end Walor Rlnsa Weer Month and WOW <br /> Garbage <br /> Can <br /> i-po EKt'ngUfsher <br /> Weler <br /> i <br /> I <br /> ice Cooler SOatNpndwash ; <br /> Extra Ica Qopa d rood ConWnara must bo WsstewAlor Conlarner <br /> slorsd 6lnctroa ofl of tha ground! <br /> EH410.02 Pogo 8 of i1 TEMP EVFKrAPP <br /> Rf1K13lIf4 ' <br />