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10. 1 am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br /> 45°F (i€food is used the following day, maintain below 41°F temperature): <br /> ® Ice chests ❑ Refrigerator <br /> ❑ Refrigerated truck ❑ Ice bath and tubs <br /> ❑ Other(specify) <br /> 11. 1 am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br /> ❑Three compartment Sink. NIA Prepackaged Goods <br /> OR <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 /> ❑ Detergent, bleach, and wiping cloths (cleaning towels). <br /> ❑Tub to store wiping cloths in bleach solution. <br /> 12, 1 am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br /> booth: NIA Prepackaged Goods <br /> ❑Water supply dispenser with warm water at a minimum of 100°F (i.e.5-20 gallon container with spigot). <br /> ❑ One separate tub(bucket or basin)for the collection of rinse/wastewater. <br /> ❑ Paper towels and pump-style soap container. <br /> 13. Names of responsible persons to be present in booth during all hours of operation: <br /> Znanmin Wang <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 /> this event. <br /> 14, Completed by: <br /> 1 2 Z <br /> Ignature Title Dat <br /> 5-20 GaL <br /> Health Permit Hand wash Water <br /> Stamp wlChafhng <br /> Dish <br /> Paper Hand Towels <br /> Soap dispersSBr <br /> Cutting Board Sanlhzer bucket- <br /> bleach&water for <br /> Propane Stove Blew stonng wiping cloths <br /> Booth must be on <br /> Concrete,Asphalt. <br /> Plywood,or a Tarp. <br /> Propane Tank <br /> 'A1110 J Soap and Waler Rinse Water Bleach and Water <br /> Garbage <br /> Can <br /> Fire Bxtmguishor <br /> EMIYa <br /> Water <br /> Ice Cooler 1 5 Gal Hand wash <br /> Ewe!ce Hags B Food conramers must be Wastewater Container <br /> sromd 6 w,hes off or the ground! <br /> EHD 16-C2 Page 6 of 11 TEMP EVENT APP <br /> O8/01/16 <br />