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• j 10. I am providin <br /> 45 F if fo 5 the following cold temperature control for the cold holding of potentially hazardous foods below <br /> od'rs Used the following day, maintain below 41 F temperature): <br /> ❑ Ice chests ❑Refrigerator <br /> ❑ Refrigerated truck ❑Ice bath and tubs <br /> [Other(specify) �-?�2 2.r Aw t cR ('re cx" <br /> l <br /> 11. 1 am providing the following items Within my booth for the sanitary cleaning of food preparation utensils: <br /> OR OThree 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 /> ❑ Detergent, bleach,and wiping cloths(cleaning towels). <br /> 0 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 /> gOne separate tub(bucket or basin)for the collection of rinsetwastewater. <br /> Paper towels and pump-style soap container, <br /> 13. Names ol responsible persons to be present in booth during all hours of operation: <br /> LlS lei S CX J o1�v� rl� r1C t,n <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. R tum orl inal to festival coordinator three weeks iprior to <br /> this event, <br /> 14. Completed by: <br /> Sin ure Title bate <br /> 5.10 Gal. <br /> Health Permit Hand wash Water <br /> Slerra vdChalrag <br /> Ulsh Paper Hand Towek <br /> Soap dispenser <br /> Cush BOgrtl Saneasr OudtN- <br /> C Dleaeh 6 watarlor <br /> Bleach ��^D w p rq dWhs <br /> Propane Slow <br /> Boolh must be on <br /> concrete,Asphalt, <br /> 'Plywood,or a Tarp. <br /> Propane Tank <br /> Soap arW or Rinw Walor Bleach VW Walar Garbage <br /> ,.....> r Can <br /> FVe ExlkrDuisher Eslra <br /> Wabr <br /> Ice Cooler 5.GalHWWW48h <br /> Earn roa Baps 6 Food Coma*M De* yyaslewarer CorMalnx <br /> spored.6lndws oNor the i7MMP <br /> COMPLETE BOTH SIDES AND RETURN WITH EXHIBITOR AGREEMENT <br />