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10. 1 am providing the following cola temperature control for the cold holding of putentially 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 FWce bath and tubs <br /> ❑ Other(specify) <br /> 11. 1 am providing the following items within my booth for warewashing: <br /> ❑Three compartment sink. <br /> OR <br /> �ree 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 /> 12. 1 am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br /> etergent, bleach, wiping cloths(cleaning towels), and a tub to store wiping cloths in bleach solution. <br /> 13. 1 am providing the following for adequate hand washing facilities, but separate from utensil wash within my booth: <br /> ter supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). A <br /> separate tub (bucket or basin) for the collection of rinse/wastewater. Paper towels and a pump-style soap <br /> container. <br /> 14. Na es of responsible persons to be present in booth during all hours of operation: <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 vent. <br /> 15. Completed by: <br /> t� Signature Title Date <br /> 5-20 Gal. <br /> Health Permit Hand wash Water <br /> Stemo w/Chaffing <br /> Dish <br /> Paper Hand Towels <br /> Soap dispenser <br /> Cutting Board Sanitize'bucket- <br /> bleach&water for <br /> Propane Stove Bleach storing wiping cloths <br /> Booth must be on <br /> O Concrete,Asphalt, <br /> Plywood,or a Tarp. <br /> Propane Tank <br /> Soap and Water Rinse Water Bleach and Water Garbage <br /> Can <br /> Fire Extinguisher <br /> Extra <br /> Wafer <br /> Ice Cooler I�—� 5 Gal Hand wash <br /> It Extra Ice Bags&Food Containers must be Wastewater Container <br /> i - stored 6 inches off of the ground! <br /> EHD 16-02 Page 8 of 11 TEMP EVENT APP <br /> 7/14/15 <br />