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10. 1 am providing the following cold temperature control for the cold holding of potentially hazaraous tooas Delow <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 /> El der(sp-rifir) - <br /> 11. 1 am providing the following Items within my booth for the sanitary cleaning of food preparation utenslls. <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 /> solunon tone tablespoon or Dteacn per gallon of water). <br /> Detergent, bleach, and wiping cloths(cleaning towels). <br /> Test strips to measure sanitation levels for bleach solution measuring 100ppm. <br /> Tub to store wiping cloths in bleach solution measuring 100ppm. <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 pum"ty*soap container. <br /> 13. Name nsib 'to be present' booth during all hours of operation; <br /> "tremrrt+ant" All su►,iPrt to ir,s rinn Map". mFlka s rnnu of this apnliration in <br /> preparation for this event. A copy of this checklist must be In the booth at all hours of <br /> preparation and operation]Retum oLiginal to festival coordinato—r-threq weeks Wor to <br /> 14. Completed by: <br /> S gnature Title Date <br /> - - --, szo Gad.__. <br /> Health Permit ` <br /> afth P*Mr Herd Tw li <br /> Spa)d�nYr <br /> �, �Board SNh& bWilel- <br /> 6M"Cfl✓k Ml�f fOr <br /> Booth must be on <br /> ConCrete.Asphalt, <br /> Plywood,or a Tarp. <br /> ProPUH 7enN <br /> —aria wow Kin.walir tw.M ana wear t <br /> Can <br /> F1re Ex""Ww <br /> E,N a <br /> Weser <br /> Ice Cooler 5 r..i"ena..alm <br /> III lc*Bpi 100d Lb�lft IIRrK 61 W"*V0lr conlelrter <br /> &--&z E.-r-"dr.a cw P'"d, <br /> EHD 18-42 Page a of 11 TEMP EVENT APP <br /> al1114 <br />