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MO. <br />11.I am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br />□ Three compartment sink. <br />OR <br />Detergent, bleach, and wiping cloths (cleaning towels). <br />IjQ Tub to store wiping cloths in bleach solution. <br />12 <br />Paper towels and pump-style soap container. <br />13. <br />14. <br />Paper Hand Tow ala <br />Soap dispenser <br />Cutting Board <br />BleachPropane Stove <br />Propane Tank <br />Rinse Waler <br />fire Eximguiaher <br />rJ <br />COMPLETE BOTH SIDES AND RETURN WITH EXHIBITOR AGREEMENT <br />"0 Ice chests <br />□ Refrigerated truck <br />□ Other (specify) <br />□ Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />t^LOne separate tub (bucket or basin) for the collection of rinse/wastewater. <br />□ Refrigerator <br />□ Ice bath and tubs <br />Extra <br />Water <br />5 Gal I land wash <br />Wastewater Container <br />5-20 Gal <br />Hand wash Water <br />Sanitizer bucket­ <br />bleach & water for <br />Storing wiping cloths <br />Extra /ce Sags S Food COnfa/ners raws/ be <br />stored 6 inches off of the ground! <br />Stemo w/C hatting <br />Dish <br />Ice Cooler <br />...............F <br />1A A. <br />ignature Title <br />Soap and Waler <br />I am providing the following cold temperature control for the cold holding or potentially hazardous foods below <br />45T (if food is used the following day, maintain below 41 °F temperature): <br />Date <br />I?[ Health Permit f <br />'P 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 />d ' 1 ~ <br />Garbage <br />Can <br />1^1 I <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, ora Tarp. <br />Name^of responsible persons to be present in booth during all hours of operation: <br />•‘Important** 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 booth at all hours of <br />preparation and operation. Return original to festival coordinator three weeks prior to <br />X. this event ------------ <br />Completedby-J^l^ <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: