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10. 1 am providing the fogoWng cold temperature oontrol for the odd hdding of potentially hazardous foods bellow <br /> 45`F(if food Is used the folbwing day, maintain below 41'F temperature): <br /> ® Ice chests ❑ Refrigerator <br /> ❑Refrtgoraterd truck ❑ Ice bath and tubs <br /> ❑ Other(specify) <br /> t 1. I am providing the following Hems within my booth for the sanitary cleaning of food preparation utansiis_ <br /> ❑Th me 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(orte tablespoon of bleach per gallon of water), <br /> ® Deltlrger'It, bleadt, and wiping cloths(cieaning 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 ulensd wash ►vlthln my <br /> booth' <br /> ®Water supply dispenser with warm water at a minimum of 1 DOOF(I e, 5-20 gallon container with spigot). <br /> ® Ono separate tub(bucket or basin)for the collection of rirw.AWasimvater. <br /> ® Paper towels and pump-yiP soap container <br /> 13. Names of responsible parsons to be present in booth during all hours of operation-. <br /> Guadalupe Jlmene4 Christian Donato <br /> "Important" AJI food vendor booths am suf jed to Inspection. Please make a copy of this appro abon in <br /> preparation for this event. A copy of this checklist must be In the booth at all hours of <br /> preparation and operation, Retunn original ttval coordinatgr throo weeks 1prior <br /> this event <br /> 14. Completed by 5/14/25 <br /> Signature Title Date <br /> Health Pefmlt �+�wire. <br /> g..��rCr.nrq <br /> ur, <br /> Pew Wry}Tgnyr♦ <br /> 6..ep dyaiw <br /> su,u. aafr <br /> sir►VMW ry <br /> ncwr..• ek.7 rrr.y•+ri'+a din. <br /> r <br /> Broth must to on <br /> Corvate.&vhart, <br /> t�G Qlywood.or a Tarp <br /> nrwti raft - - ,..._. - - � � - <br /> s�narrrr F+rr.Nrw er.�.:xwr� Galba¢� <br /> F►.E,trr_v�l� -- -�� _ _ - Can <br /> A Z <br /> rICIB Cooler <br /> FrWkinAvpi or"CA.W.w■r.�xl. I WWwtlxCWhWff <br /> - Mena P•Tees nr d <br /> EYiQ 16{t� Drce d d I I T F31P"'PIT APP <br /> oQovla <br />