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10 <br />11. <br />□ Three compartment sink. <br />OR <br />□ Detergent, bleach, and wiping cloths (cleaning towels). <br />□ Tub to store wiping cloths in bleach solution. <br />12. <br />13. <br />“Important** <br />14. <br />Health Permit <br />Paper Hand Towels <br />Cutting Board 1 Bleach /Propane Stove <br />Propane Tank <br />Bleach and WaterRinse Water <br />Fire Extinguisher <br />JIce Cooler <br />COMPLETE BOTH SIDES AND RETURN WITH EXHIBITOR AGREEMENT <br />__J <br />Soap and Waler <br />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 41 °F temperature): <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth. <br />Ex(ia ice Bags <S Food Containers must be <br />stored 6 inches off of the ground1 <br />Slemo w/Chaffing <br />Dish <br />|~I Refrigerator <br />Cl Ice bath and tubs <br />Extra <br />Water <br />Garbage <br />Can <br />Sanitizer bucket <br />bleach & water tor <br />storing wiping cloths <br />5 Gal I land wash <br />Wastewater Container <br />5-20 Gal <br />Hand wash Water <br />L <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br />(X <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 />Title <br />Rjjce chests <br />' |~| Refrigerated truck <br />□ Other (specify) <br />1 \'\D^\ <br />Date <br />Booth nius! D€ on <br />OOP' oh:, b. <br />P|yWl ! f A l.:ip <br />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 />Completed b.x-fiWv <br />’ Signature <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 />f^Paper towels and pump-style soap container. <br />Names of responsible persons to be present in booth during all hours of operation <br />______a __________________________________ <br />5 bo <br />Soap dispenser j ------