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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 41'F temperature): <br /> ® Ice chests ❑ Refrigerator <br /> ❑ Refrigerated truck ❑ Ice bath and tubs <br /> ❑ Other(specify) <br /> 11. i am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <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. I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br /> booth: <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 /> *"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 /> his <br /> �o14. Completed by: )7 v L-� <br /> Signature Title D to <br /> 5-20 Gal. <br /> Health Permit Ste Hand wash water <br /> mo wlChaffing <br /> Oish <br /> Paper Hand Towels <br /> Soap tlispenser <br /> GutBnp Board SamGzer bucket- <br /> bleach$water For <br /> Propane Stove SEoach stonng wiping cloths <br /> Booth must be on <br /> Concrete,Asphalt, <br /> Plywood,or a Tarp. <br /> Propene Tank <br /> Soap and Water Rinse Water Breach and wale Garbage <br /> Can <br /> Fire Exlinpuisnar <br /> F:tra <br /> Water <br /> Ice Cooler 5Gal Hand wash <br /> Extra Ice Sags 8 Food Containers mus!be Wastewater Conlamor <br /> stared 6 inches off of the ground! <br /> EMp 16-02 Page 8 of 11 TEMP EVENT APP <br /> 08101f16 <br />