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- 40.potentially hazardous foods below <br />11.I am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br />OR <br />□Istergent, bleach, and wiping cloths (cleaning towels). <br />□ Tub to store wiping cloths in bleach solution. <br />12.my <br />13. <br />14. <br />Paper Hand Towels <br />Soap dispenser <br />Cutting Board <br />Propane Stove Bleach <br />i <br />Rinse Waler <br />Fira Extinguisher <br />COMPLETE BOTH SIDES AND RETURN WITH EXHIBITOR AGREEMENT <br />fy Ice chests <br />□ Refrigerated truck <br />□ Other (specify) <br />Extra lea Bags A Food Containars must bo <br />stored 6 Inches off of the ground! <br />Stemo w/Chafflng <br />Dish <br />□ Refrigerator <br />□ Ice bath and tubs <br />Extra <br />Water <br />5 Gal Hand wash <br />Wastewaler Container <br />Sanitizer buckel- <br />bleach & waler lor <br />storing wiping cloths <br />4 <br />5-20 Gal. <br />Hand wash Water <br />A I—T.. ,ili I r—i <br />Title <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />— <br />’“Important** <br />Date <br />I Health Permit <br />Propane Tank <br />--------------------A <br />w I <br />Z_____________“/ <br />Ice Cooler <br />3U 0 <br />^J-J : Garbage <br />! Can <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 />tn is <br />Completed b<^^zZZ<-- <br />/ Signature <br />I am providing the followii >ld temperature control for the cold holdir. <br />45°F (if food is used the following day, maintain below 41 °F temperature): <br />r~——o _____ <br />Soap and Water <br />□ 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 />My <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within <br />booth. <br />J^tf/ater 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 />Names of responsible persons to be present in booth during all hours of operation: