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iO- <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensils11 <br />[^three compartment sink <br />OR <br />QzBetergent, bleach, and wiping cloths (cleaning towels) <br />□ Tub to store wiping cloths in bleach solution <br />12 <br />QA/Vater 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 />0^Paper towels and pump-style soap container <br />13. <br />Completed by: 14. <br />Health Permit <br />Paper Haro <br />Soap dispenser <br />CutinQ Board <br />BleachPropane Stove <br />fl fl <br />Rmse Water <br />i Ice Cooler <br />COMPLETE BOTH SIDES AND RETURN WITH EXHIBITOR AGREEMENT <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 />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth <br />Stem© w/Chafftng <br />Dish <br />El Refrigerator <br />□ Ice bath and tubs <br />Sanaa®* <br />oieach & water ‘or <br />storing wpng ooms <br />CTtee chests <br />□ Refrigerated truck <br />0 Other (specify) <br />Extra <br />Water <br />5 Gal I land wash <br />Wastewater Contavwr <br />5-20 Ga <br />Hand wash Water <br />Booth mus’ w or. <br />Cooorete. A a’* <br />J f T,.'p <br />'Signature <br />All food vendor booths are subject to inspection. Please make a copy of this application n <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 />this event <br />Title <br />“Important** <br />I am providing the following temperature control for the cold holding of potentially hazardous foods below <br />45°F (if food is used the following day, maintain below 41OF temperature) <br />Soap and Waler <br />Date <br />Extra lea Bags ft Food Containats must ba I <br />stored 6 inchax ottotlha ground’ I , <br />Names of responsible persons to be present in booth during all hours of operation: <br />—jl I Garbage <br />Can <br />I Ftfa Exunouisher <br />Propane Tank ----------------------1 <br />)