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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. 1 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 /> 13. Names of responsible persons to be present in booth during all hours of operation: <br /> Nicole Moore <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 /> pre ra n and operation. Return original to festival coordinator three weeks prior to <br /> th Owedt. <br /> 14. Completed by: i <br /> Sig ature Title Date <br /> 5-20 Ga[. <br /> Health Per Hand wash Water <br /> Stemo wlChafing <br /> Dish <br /> Paper Hand Towels <br /> Soap dispenser <br /> Cultinp Board Sanitize,bucket- <br /> bleach&water for <br /> Propane Stove Bleach storing wiping Goths <br /> Booth must be on <br /> Concrete,Asphalt, <br /> Plywood,or a Tarp. <br /> Propane Tank - <br /> Soap and Water Rlnse Water Bleach and Water Garbage <br /> Can <br /> Fire Extinguisher <br /> Extra <br /> Water <br /> Ice Cooler 5 Gal Hand Sh <br /> Extra Ice Bags&Food Containers must be Wastewater Container <br /> stored 6 inches offal the ground! <br /> EHQ 16-02 Page 8 of 11 TEMP EVENT APP <br /> 08/41116 <br />