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10 1 an providing the fo€lowing cold temperature control for the cold holding of potentially hazardous foods bekmr <br /> 45°F (if Food is used the following day, maintain below 41°F temperature): I�P <br /> r <br /> ❑ lee chests ❑ Refrigerator <br /> ❑ Refrigerated truck ❑ice bath and tubs <br /> ❑ Other(spe^ —�— — -- — <br /> 11. 1 am providing the following items within my booth for the sanitary cleaning of food preparation utensils- <br /> Three compartment sink. f V f <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: �f <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 rinsetwastewater_ <br /> ❑ Paper towels and pump-style sim container <br /> 13. Narpes of responsible persons to be pre nt in booth during 11 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 event <br /> 14, Completed by: 49M= N �`1j-ll l� -C , <br /> Signature Title Date <br /> � s�o car <br /> -Heal <br /> a.w <br /> Papr Hayed T;7- <br /> Saaap ci�rpnr <br /> So-'ncw b ckw <br /> P+eon"Swv" wa.m a vol ow tr <br /> Buarn �*1p�"baety <br /> BOp[h must be on <br /> Concrete,AsphaR, <br /> P,o,.,,.r�+k Prywood,Ot a Tarp, <br /> ��rK 4W.+ar Rryr�YM"r Bloom ri0 Wa4ar <br /> Garbage <br /> Can <br /> vVrbr <br /> Ice Cooler <br /> F. "kr trap:d 1-ax1 Co�t�r+ers sr S Go Hold,,,u, <br /> aK>+wf a a+:�ea e�d ene vv"'""ita.Cis <br /> I � <br /> EHa 0 02 <br /> 06101/14 Page 9 0111 <br /> TEMP WENT APP <br />