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10. <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensils.11 <br />□ Three compartment sink. <br />OR <br />EfDetergent, bleach, and wiping cloths (cleaning towels) <br />0^Tub to store wiping cloths in bleach solution <br />12. <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 nnse/wastewater. <br />{ZT Paper towels and pump-style soap container. <br />Names of responsible persons to be present in booth during all hours of operation13 <br />April 2, 2025 <br />Completed by: 14. <br />Date <br />Paper Hand Towels <br />1 BleachPropane Stove <br />FTr, <br />Bleach and Water <br />Fire Extinguisher <br />Si <br />TEMP EVENT APRPage 8 of 11 <br />I.' .•’.Y' ~ <br />Soap and Water <br />/ <br />Rinse Water <br />EHD 16-02 <br />08/01/16 <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 />□ Ice chests <br />□ Refrigerated truck <br />□ Other (specify) <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 />Stemo w/Chaffing <br />Dish <br />□ Refrigerator <br />0^1 ce bath and tubs <br />Extra <br />Water <br />5 Gal Hand wash <br />Wastewater Container <br />Garbage <br />Can <br />Sanitizer bucket­ <br />bleach & water for <br />stonng wiping cloths <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp <br />5-20 Gal . <br />Hand wash Water <br />Ice Cooler j <br />Health Permit <br />Extra Ice Bags & Food Containers must be <br />stored 6 inches off of the ground' <br />TitleSignature <br />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 />this event. <br />"Important** <br />! Cuttnq Board <br />I Propane Tank <br />| Soap dispenser