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�, SNOHOMISH <br /> HEALTH DISTRICT Equipment List <br /> WWW.SNOHD.ORG <br /> Facility name: UltAte,P1t,1 <br /> List all food service equipment, including make and model numbers. Examples include, but are not limited to, <br /> refrigerators, sinks, stoves, ovens, steam tables, blenders, ice machines, ventilation hoods, and all countertop <br /> appliances. If make and model number cannot be found, a picture of the equipment is required. The item <br /> numbers on this list must be the same as the item numbers for the equipment on the floor plan. <br /> All equipment ID numbers must correspond to location on floor plan. Equipment must be commercial grade <br /> and meet American National Standards Institutes (ANSI) standard (NSF, ETL or UL Sanitation listed). Only <br /> one item per line. <br /> Sample Equipment List <br /> ID # Kind of equipment Make Model # <br /> 1 Refrigerator 8'x8' walk-in ACME R-789W1 <br /> 2 Ice machine GAPP IM-987 <br /> 3 Rice cooker ACME CR-543 <br /> 4 3-compartment dish wash sink (with 2 drainboards) ACME S-3CWD <br /> ❑ The equipment list is included on floor plan. <br /> COLA O tee►' TOtinte; N IA <br /> 2- SCuil w,c i Price Puke. S -lo.2- R r <br /> 3 Cask-ex C outn-b-er N ifr\ <br /> 4 wirlp,CaurrLF td-r;geroor &fiejruty, - A r Uc, -12/At-IC - 2-3 <br /> 3 ice- 1vlctc1i ne, i1%1GZni-,o t.1JoG UP F D I`%z% A - <br /> Hood, CQFtivt c re. 31;5e60--2, <br /> flyer Ava i-ko <br /> G,as Poole_ Vf i cc n 1,i;1•1 <br /> crick pot I/vi n V2 B► — NAT <br /> Environmental Health Division <br /> 3020 Rucker Avenue, Suite 104 ■ Everett, WA 98201-3900 ■ fax: 425.339.5254 ■ tel: 425.339.5250 <br />