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t10, ' 1-am providing the following cold temperature control for the cold holding of potentially hazardous foods below l <br /> 45°F(If food Is used the following day, maintain below 41 OF temperature): i <br /> Jl Ice chests ❑ Refrigerator <br /> ❑ Refrigerated truck ❑ Ice bath and tubs <br /> ❑ Other(specify) <br /> I <br /> 11. 1 am providing the following Items within my booth for the sanitary cleaning of food preparation utensils: <br /> 4 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 /> I <br /> ❑Tub to store wiping cloths In bleach solution. <br /> 12. i am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br /> booth: j <br /> Water supply dis enser with warm water at a minimum of 10011E i e 5-20 gallon container with spigot), <br /> p {. g <br /> ❑One separate tub(bucket or basin)for the collection of rinse/wastewater. <br /> I <br /> Paper towels and pump-style soap container. <br /> 13. Names of responsible persons to be pre e t In booth durina all hours of operation: <br /> hte <br /> -f -�- <br /> ""Important" All food vendor bodths 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 coordinintor three weeks prior to 1 <br /> this event, 1 <br /> ; <br /> 14, Completed by: ,/GG J _ �v �:� /L31r ►^ 5/9/24 <br /> 81 nature Title pate <br /> 6.2o Cal. <br /> Health Permit Hendwash Waler I' <br /> i <br /> Slarno wlChotfnp !iI I <br /> Dish Paper Hand Towels <br /> Soep dispenetr � ' <br /> CUlllnp Board sadllzor bucke <br /> t <br /> - <br /> bleach S walar for <br /> propono Stove Bleach storing Mping cloths i <br /> t <br /> Booth must be on <br /> Concrete,Asphalt, <br /> Plywood,or a Tarp. <br /> Proaano Tank <br /> .• soap end Walor Filnso Water Bloach erxl Water <br /> i <br /> t• - Garbage <br /> Can <br /> .'•j:'.,t Fare EM igulsher <br /> foe Cooler 8 Out Hand tvaslt i <br /> CDdra Ica gays d Food Con[elners must bs Wastewater Contolner <br /> — steed O lnchos oil of the ground/ 1 <br /> EHO 18.02 Page 8 of 11 TEMP EVEW APP <br /> �RJOtl10 I <br /> II <br />