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10, <br />11.I am providing the following items within my booth for warewashing: <br />□ Three compartment sink. <br />OR <br />12. <br />13. lam providing the following for adequate hand washing facilities, but separate from utensil wash within my booth: <br />14 snt in booth during all hours of operation:A <br />••Important’* <br />15.Completed by: <br />Signature Title Date <br />Health Permit <br />Pap« »<and Tow^t <br />SoodKCMnw <br />8»Mch <br />| *w»rr* <br />and Water RmMWMw OtMchandWMM <br />foe Cooter <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br />Detergent, bleach, wiping cloths (cleaning towels), and a tub to store wiping cloths in bleach solution. <br />EJ Ice chests <br />□ Refrigerated truck <br />J Other (specify) <br />J3 Water supply dispenser with warm water at a minimum of 100°F (l.e. 5-20 gallon container with spigot). A <br />separate tub (bucket or basin) for the collection of rinse/wastewater. Paper towels and a pump-style soap <br />container. <br />O 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 />Stemo WChaffinQ <br />Dteh <br />□ Refrigerator <br />•0 Ice bath and tubs <br />&antUMr buck**- <br />& wmw Kv <br />tionng w«p»ng <br />S-20 Gai <br />HandwathWMv <br />Garbage <br />Can <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp <br />Names of responsible persons to be pi <br /> <br />/Ul 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 wks prior to <br />this event <br />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 />I CutMnp Board