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i0. I am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br /> 45°F(if food is used the following day,maintain below 4VF temperature): <br /> ❑ Ice chests ❑Refrigerator <br /> ❑Refrigerated truck ❑ Ice bath and tubs <br /> Other(specify) n/a <br /> 11. I 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 Goths 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 /> Ejffater 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 um s le soa container. <br /> 13. Names of responsible persons to be present in booth during all hours of operation: <br /> Ursula Kemp-Paden <br /> "important' AM 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, r <br /> � n Title Date <br /> sza cal. <br /> Health Permit Hand warn waler <br /> _ P <br /> Ssemo wlChafGrg <br /> Oish <br /> Paper Nand Towels <br /> Soap dlspansar <br /> Cutsrnp 9oard <br /> Sa ,or Imkat- <br /> daatll water for <br /> Propene SWYa Bleach vicidn9%iping cloths <br /> Booth must be on <br /> Concrete,asphalt. <br /> Plywood,or a Tarp. <br /> Propane Tank <br /> Soap and Water Rinse Water 63ea�and Wafer <br /> Garbage <br /> Fire Extinguisher Can <br /> Fatra <br /> water <br /> Ice Cooler 5 Gail Hand wash <br /> Extra tce Bags&Food COMamrs must be Wastewater Container <br /> Shoed 6 Inches off of the proww! <br /> EHO 16-02 Page 8 of 11 TEMP EVENT APP <br /> 08tp1f 15 <br />