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10. I can providing the follovAng eald temperature control for the cold holding of polontlally hazardous foods below <br /> 45'F (If food is used the following day,maintain belaw 41`F temp©ralwo)_ <br /> ® ice chests ❑ Rafr*rator <br /> ❑ Refngeratod 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 /> ❑ Throo compartment sink. <br /> 0R <br /> 2 Throo dezop tubs (basins 6-8 Inches minimum), one for soapy water, one for rinsing and one for a bleach <br /> solution (one tabiesPoon of bleach per gallon of watef) <br /> ® Detergent, bleach, and vriping cloths (leaning tav0s) <br /> ❑ Tub to store YAplrg Goths in bleach solution. <br /> 12. 1 am providing the folloveng for adequate hand washing facilities, but separate from utensil wash wtthln my <br /> booth: <br /> Q Water supply clsponser with warm vrater at a minimum of 100'F (i.e.�20 gallon container with spigot). <br /> ® One separate lub(bucket or basin)for the collection of rinseslwastowator. <br /> ® Paper toms,and pump-style rsogp container. <br /> 13. Names of responsible parsons to be present in booth during all hows of operation <br /> Knsllna Rutz <br /> ••Lmportant'* AJI food vancW booths are subod 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 a d operation. Rctvm arilginal to fostivat cooMlnator three weeks prior to <br /> this ovont. <br /> 2/27/26 <br /> 14. Com;lotod by: <br /> Slonaturn Title Data <br /> Health Pcm�li "-,dwo h"`'''" <br /> [+win.�tuRn� <br /> Pth <br /> iu11Y[IKw-lw <br /> Cj1. SM9100 t-1 N <br /> Borth mL41 be or: <br /> All Coraula,Asphak <br /> �— - PIlvr ,or a Trip <br /> Rn;wrw Tw•Y - - <br /> ^� Gal <br /> ___ FI�E.ari�i7r <br /> ��y EfilY <br /> 1\� <br /> !oa Cooler ---� -- sorYu.Yawan <br /> 1 ._i l r 5h;,l f,..'...>�....r•su1 is Y��lMw�Y�siYtr <br /> E HD 1 C,ll7 Page 0 or t l T E 1JP E1rh'r AP P <br />