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l , <br /> 10. 1 am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br /> 450F(if food is used the following day, maintain below 41 OF temperature): <br /> ; ce chests [] Refrigerator <br /> ❑ Refrigerated truck ❑ Ice bath and tubs <br /> ❑Other(specify),._ .___-..— <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 water, one for rinsing and one for a bleach <br /> ["Three deep tubs (basins 6-8 inches minimum), one for soapy <br /> solution (one tablespoon of bleach per gallon of water). <br /> Detergent, bleach, and wiping cloths(cleaning towels). <br /> E.q 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 /> EJ'Water supply dispenser with warm water at a minimum of 100°F(i.e. 5-20 gallon container with spigot). <br /> P"One separate tub(bucket or basin)for the collection of rinse/wastewater. <br /> S?-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. to fest4va! coa__r.'ra 'toe' tl�ree <br /> this event <br /> 14, Completed by: <br /> tnp,vlQG ��( �S � Z-Z SignatureTit3r" <br /> 5-20 r,�.nl <br /> ,.«_..�.. (land wash Wffier <br /> Health Permit Stemow/Chaffing <br /> risk -. Paoer Land Towels <br /> Sanmzer I,uaol• I, <br /> Gulling Board __-_ _ }} bleach&wat'n for <br /> slonng wNrng cJnlhs <br /> Borth Illtf`, UI; <br /> nc! <br /> s _Propane rank r <br /> 1 LSospand Water LaeI Bleach and Water Garbage <br /> Can <br /> f irc Exla.guisher ' <br /> Water I � <br /> Ice Cooler <br /> ,_ 5 Gal Hand wash .,....._-/ <br /> Extra ke Bags 8 Food C061810ers rnasf be Wastewater Grxaamer <br /> stored 6 inches odorihe ground! <br /> COMPLETE. BOTH SIDES AND RETURN WITH EXHIBITOR AGREEMENT <br />