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10 <br />I am prove.rg the •ollcwing items .vimm my boeth ‘y tie ssn •£./ cieam.-ig of food pteparat.on i.t=r.si's <br />i_Tnree compa-.m^-it si’1-. <br />OR <br />ir: Detergent. b'eae'Y and .•.0 "Z "Icths mles^mg s <br />Y. -b to store wiping oioths in blea'..1' sc j-ton msasor-g ‘ OCopm <br />13 Na operation' <br />‘'Important*’ <br />Completed by: <br />Signature Date <br />Health Permit <br />Os-- <br />OiV <br />Ice Coo'er ■ <br />' Refrgeratpr <br />ice bath and tubs <br />ti‘ '.Zi' L.c;5 ■ <br />.* '"if i -Or <br />s^r-og.vir ;1 <br />■ <br />L . > TzTl <br />coot-, fws: be <br />:'.C"3'ete. Asp-.ei: <br />j PI/.-.os’J r-jliv <br />J3 <br />LJ ih'ec deep tuos (basins 3-5 -'•ones — <br />so'jt'on tore tablespoon ct b'eatm per galiv <br />_yfce chests <br />; J Refrigerated t'uck <br />L~ Other (speerfy) <br />l am p-o’c ng ‘hg :p.!o;ving cold te:rpem:..i'e emtrei fc; the cold hoidi~g cf potential!'/ haaardcu'S ■cods be'o <br />~:;'F f feed is used rite fc.cwltn day, 'rarntain Lelc'.'.' <1 ,SF tempe-aturoi: <br />5 ’ ■■ c'':'t,|:.g t-e ■jho... ng o- adequate nand 'sasu q fan.ies h.t seoarate ' om ute*s' was: wiihir; mv <br />booth' ' ' <br />mum one soapy water, ore fo rinsing and cue C' a c each <br />m' -a ster: <br />__ Water supply dispenser v.rtn worm vetor at ; -i- mum o? 'C3T :c. 5-2C gallon oc-tainer v/th spigot.) <br />.t^O-e separate tub 'buc-tet or bas n> fe-tre co eotio" ofr nse/.vastc.vater. <br />[Pr’acer towels and pump-sty’e soar: ccma <br />6s sr ters <br />— 15S- stops to measure sanitabon eve’s fo' bleac" solution reasutirg 1 CCppm <br />r«. food vendor booths are subject to inspection -’case make a copv cf th s apo'caticn. n <br />preparation -'o' this event A coby o- this oheok/st must be in the booth at a! ours of <br />n'eparr:. on and operatic- Return original to festival coordinator three weeks prior to <br />this event.