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10. 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 /> ® Ice chests Refrigerator <br /> ❑ Refrigerated truck ❑ Ice bath and tubs <br /> ❑x Other (specify) Ice chillars <br /> 11 1 am providing the following items within my booth for the sanitary cleaning of food preparation utensils- <br /> [7] Three compartment sink <br /> OR <br /> ❑ Three deep tubs (basins " inches minimum), one for soapy water, one for nnsing and one for a bleach <br /> solution(one tablespoon of bleach per gallon of water). <br /> ❑ 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 rinselwastewaler. <br /> ❑ Paper towels and pumrrstvle soap conta-ner. <br /> 13. Names of responsible persons to be present in booth dunng all hours of operation <br /> Bfn Lugo <br /> "lmportan 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 tooth at all hours of <br /> preparation and operation. Return orm" Inal to festival coordinator three weeks prior to <br /> thls event <br /> 14. Completed by: <br /> Signature Title Date <br /> 5-10- - r-r <br /> cap <br /> l Health Permit "'"itl"""`""'�' <br /> Storm rrChiXvq <br /> D6h <br /> 1 Paper hind-Owen <br /> S[00 6�peraer <br /> Cutting Boars Sart¢e bui,el- <br /> ckB[h d wits for. <br /> ProFwe Store 6laach storing ,peg cloths <br /> Booth must be on <br /> Concrete,Asphaft <br /> Plywood r a Ta rp <br /> Prow*risk <br /> Soap and water R+ se7L, <br /> rho-Water Garbage <br /> -- -- Can <br /> F�rE EbnWisher <br /> E tiro <br /> water <br /> r1ce Cooler I — :- r3 Y 5 Gal ryerW wFsh <br /> E..,.x»B.p!6 loos Co�rr.nei!m.tr Or 1 Wa9.rrter CeM+wyr <br /> An1Cd 61rlUts Orr N the grau+wi+ _' <br /> COMPLETE BOTH SIDES AND RETURN WITH EXHIBITOR AGREEMENT <br />