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10. <br />11. <br />OR <br />12. <br />13. <br />Completed by__-c-14. <br />tire Date <br />Health Permit <br />Paper Hand Towels <br />Cutting Board <br />Propane Stove <br />Bleach <br />J 0IfPropane Tank <br />Rmse Water Bleach and Water <br />Fire Extinguisher <br />1 Ice Cooler <br />□ Ice chests <br />□ Refrigerated truck <br />□ Other (specify) <br />Extra <br />Water <br />5 Gal Hand wash <br />Wastewater Container <br />Garbage <br />Can <br />Slemo w/Chafting <br />Dish <br />Sanitner bucket­ <br />bleach 8 water lor <br />storing wiping cloths <br />Booth must be on <br />Concrete. Asphalt <br />Plywood or a Tarp. <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br />□ Three compartment sink. <br />Title <br />Soap and Water <br />Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot) <br />0 One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />Paper towels and pump-style soap container. <br />1 WKS SSSK* "*“• ““ <br />□ Refrigerator <br />□ Ice bath and tubs <br />Exira Ice Bags & Food Containers must be I <br />stored 6 inches ott ot the ground' | <br />COMPLETE BOTH SIDES AND RETURN WITH EXHIBITOR AGREEMENT <br />^Providing the following for adequate hand washing facilities, but separate from utensil wash wrthin my <br />5-20 Gal <br />v- Hand wash Water <br />Soap dispenser \ <br />for -sing and one for a bleach <br />® Detergent, bleach, and wiping cloths (cleaning towels) <br />13 Tub to store wiping cloths in bleach solution <br />Names^^^0^^e^ <br />“Important- All tafo vendor booths are subject to inspection. Please make a copy of this application in <br />I for this event. A copy of this checklist must be in the booth at all hours of <br />th^vent operatlon geturn or'qinal to festival coordinator three weeks prior to <br />T^S: <br />Sic