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10 <br />11 <br />OR <br />C? Determent, bleach, and wiping cloths (cleaning towcis). <br />□ Tub to store wiping cloths in hleach solution <br />12. <br />'tSj Water supply dispense! with warm water at a minimum of 100’F (i.e 5-20 gallon container with spigot). <br />E One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />[J^Paper towels and pump-style soap container. <br />13. <br />14. <br />Health Permit <br />Paper Hand Towels <br />Soap dispenser <br />Cutting Board <br />BleachPropane Stove <br />Lt f r <br />Fire Extinguisher <br />Ice Cooler <br />Page 8 of 11 TEMP EVf NT M <br />/ <br />Rinse Water <br />eno 16-02 <br />06/01/16 <br />C Refr/qer^rFHi in irk <br />O Other (SpOCifv) <br />Sterno w/Chatfmg <br />Dish <br />[ | Rn<rr<jorA!Of <br />I ) k p b^fh And h»bs <br />Extra <br />Water <br />5 Gal Hand wash <br />Wastewater Container <br />5-20 Gai. <br />Hand wash Water <br />Sanitizer bucket- <br />Weach & water for <br />storing wiping cloths <br />Booth must be on <br />Concrete, Asphalt <br />Plywood, or a Tag <br />Extra Ice Bags t Food Containers most be <br />stored 6 Mies off at the ground I <br />I am providing the following for adeguate hand washing facilities, but separate from utensil wash within my <br />booth <br />K-. 1 <br />Bleach and Water I <br />»<<»»____L_ <br />Soap and Water <br />’Important** <br />fey ■■■ ' H <br />I am providing the following iinms wi’hir. my tronth for thn sanitary clAaning of food preparation utensils: <br />O Three compartment sink <br />I am proving the friHnwma cold inmperat.rm control for the mid hotdmq of pomnt.ally hazardous foods below <br />db' f (if fcuxl is used rhe fuitowiria day m.i<rM,»,n tx>«ow 41 f remporature) <br />I Propane Tank <br />Garbage <br />Can <br />Names of responsible persons to be presgnt in booth during all hours of operation: <br />//Ali 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 />vy Signature ~ Title Date <br />O Thmc deep tuh$ (basins 6 fi inches minimum), one for soapy water, one for rinsing and one for a bleach <br />solution <one tablespoon of bleach per gallon of water).