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10. 1 am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br /> 45eF(if food is used the following day, maintain below 41 OF temperature): <br /> ® Ice chests ❑ Refrigerator <br /> ❑ Refrigerated 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 /> ❑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 /> solution (one tablespoon of bleach per gallon of water). <br /> ❑ Detergent, bleach, and wiping cloths (cleaning 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 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 pump-style soap container. <br /> 13. [Names of responsible persons to be present in booth during all hours of operation: <br /> Daryl & LaJeana Charles <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 event. <br /> 14. Completed by: Daryl Charles Owner 2/21/2026 <br /> Signature Title Date <br /> 5-20 Gat. <br /> Health Permit Ste Hand wean Watsterna wlChafing <br /> Dish <br /> Paper Hand Towels <br /> Soap dispenser <br /> Cutthtg&oard SaNtizerducket- <br /> bleacn&water For <br /> Propane 5toae <br /> Bleach storing wiping Cloths <br /> Booth must be on <br /> o Concrete,Asphalt, <br /> .w. <br /> Plywood,or a Tarp. <br /> Rropane Tank <br /> Soap and Water Rinse Watar Bleach and Water Garbage <br /> Can <br /> '-re E>Amquisher <br /> Extra <br /> wa>.er <br /> Ice Cooler 5 Gal Hand wash <br /> Extra Ice Sags&Food Cantainam must he Wastewater Contalner <br /> stored 6 inches off or the ground! <br /> EHD 16-02 Page 8 of 11 TEMP EVENT APP <br /> 08/01/16 <br />