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1D. I am providing the following cold temperature control for the cW holair►g of potentially hazardous foods below <br /> 45'F (if food is used the following day,maintaln below 41'F temperature): <br /> ® Ice chests ❑ Refrlgefator <br /> ❑ Refrigerated truck ❑ Ice bath ano Wtm <br /> ❑Other(sM*) _ -- - <br /> 11. 1 am providing the following moms within my booth for the sanitary clearing of food preparat.on ute-RvIs: <br /> ❑Three compartment oink. <br /> OR <br /> 0 Three deep tubs (basins 6-6 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 tuweb). <br /> ❑Tub to store wiping cloths In bleach 5olubon_ <br /> 12. 1 am providing the following for adequate hand washing facilities, but separate from utansd wash within my <br /> booth: <br /> g Water supply dLspenser with warm eater at a minunum of 1 DOT(1 e, 5-24 gallon container with spigot►, <br /> One separate tub (bLGINCt or basil for the colleciJon of rinseMastowatnr. <br /> Paper tmvets and purn:)•StOe 5Hp container. <br /> 13. Names of responsible persons to be present in booth during all hours of operation. <br /> AfSon Dernara or Dina <br /> "Important" An food vendor bogs are SAW to inspocbon, Please make a copy of this application in <br /> pre-parabon roe this event. A copy or this cheddist must be in the booth at aft hours of <br /> preparation and operation. Roturnn original to fQStlYVI coordInator three w 5.1)rigr to <br /> his ov it t. <br /> 14. Completed by. — Date <br /> Signature Title <br /> o-au r� <br /> MwA wIh N'I W <br /> Health Permit �� .,r;IMN <br /> v,4r K-:-ra.ls <br /> Q� <br /> Cvfr�awrtl dn�+L r�kr 1:r <br /> ra..n-.siti'V d.M4 <br /> ���Nuw Booth rrv.gl bo r1l <br /> Gmcseln,Aspf�L <br /> Piywa�ad,or a Tprp- <br /> p�p•�tr1 <br /> g ar.SY4'H+ al-i+lH.r Rw.a.nG/Ira GWbape <br /> Gen <br /> Ice Cooler <br /> fJ�ali�r Grnsna <br /> Fat*a by R+7�L Ft�G�.erl�en a..sr nr J <br /> 1 EXIR EVENT APP <br /> Pagaad11 <br /> EHO 18-02 <br /> MOVI9 <br />