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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. 1 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 /> 11 Names of responsible persons to be present in booth during all hours of operation: <br /> Joe Kelley Julie Kelley <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: L. Y <br /> � � ,(�� <br /> Sign re Title date <br /> 5-21} Gal. <br /> Health Permit Hand wash Water <br /> P stamo wlCharfing <br /> Dish <br /> Raper Hand Towels <br /> Soa➢tlfspenser <br /> Cutenq Board Sandbzer bucket- <br /> bleach d water for <br /> Propane Stove Bleach <br /> storing wiping doihs <br /> Booth must be on <br /> Concrete,Asphalt, <br /> Plywood,or a Tarp. <br /> Propane Tank <br /> Soap and Water Rinse Water Bleach and Wale, Garbage <br /> Can <br /> Fire Extinquisher <br /> Extra <br /> Wace, <br /> Ice Cooler 5 Gal Hand wash <br /> Fdra Ice Begs 6 Food Containers must be Waslowater Conlainer <br /> stored 6 arches ON of the ground! <br /> EHD 16-02 Page 8 of 11 TEMP EVENT APP <br /> 08/01/16 <br />