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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 /> Detergent, bleach, and wiping cloths (cleaning towels). <br /> Tub to store wiping cloths in bleach solution <br />12 <br />13. <br />’’Important** <br />14.Completed by. <br />Signature <br />Health Permit <br />I Paper Hand Towels <br />Soap dispenser <br />Cutting Board <br />BleachPropane Stove <br />Propane Tank <br />Rinse Vifeter Bleach and Waler <br />Tire Extinguisher <br />Ice Cooler <br />COMPLETE BOTH SIDES AND RETURN WITH EXHIBITOR AGREEMENT <br />1 <br />Soap and Water <br />Extra Ice Bags & Food Containers must be <br />stored 6 inches oft of the ground' <br />Exira <br />Water <br />Garbage <br />Can <br />Sanitizer buckel- <br />Oleach & water tor <br />storing wiping cloths <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 /> 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 />Slemo w/Chaffing <br />Dish <br />5 Gal Hand wash <br />Wastewater Container <br />Booth must be on <br />Concrete, Asphalt <br />PtywoorJ ora Tarp <br />Date <br />■ I r <br />^fwater supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot) <br />ne separate tub (bucket or basin) for the collection of rinse/wastewater. <br />owner <br />Title <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 />^J^aper towels and pump-style soap container. <br />Names of responsible persons to be present in booth during all hours of operation: <br />____hprnadAt hahaknlana And clAijrlia tnrrpg_______________________ <br />5-20 Gal <br />I land wash Walot <br /> Ice chests Refrigerator <br /> Refrigerated truck Ice bath and tubs <br />I-] Other (specify) all baked gnnds will he prppar.kpd rpady tn spll at rnnm tpmp