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10. 1 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 /> (K Ice chests ❑ Refrigerator <br /> ,ate <br /> ❑ Refrigerated truck ❑ Ice bath and tubs <br /> F ❑ Other(specify) <br /> 11. I am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br /> OR Three compartment sink. <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 /> T,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 /> "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 /> �I' l� GtZl_. VJIL ��VY1i77AuUit <br /> 14. Completed by: � '4z� <br /> Sign t re Title Date <br /> 5-20 Gal. <br /> Health Permit Iland wash Water <br /> Stemo w/Chaffing <br /> Dish _ <br /> Paper Hand Towels <br /> Soap dispenser <br /> Cutting Board <br /> i \ SAN'Zer buckel- <br /> Pto ane Stnve bleach&water for <br /> p Bleach F�. storing wiping cloths <br /> Booth rnffst t„,un <br /> L �I Concrete,Asphalt. <br /> 9 Plywood or a Tarp, l <br /> i <br /> Propane Tank `=y __� <br /> Soap and Water Rinse Water Bleach and Water <br /> Garbage <br /> Fire Extinguisher <br /> Can <br /> Extra <br /> Water <br /> Ice Cooler 1, * 5 Gal Band wash <br /> Extra Ice Bags&Food Containers must be Wastewater Container <br /> sfored 6 inches off of the ground? <br /> COMPLETE BOTH SIDES AND RETURN WITH EXHIBITOR AGREEMENT <br />