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10, 1 am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br /> t 45'F (if food is used the following day, maintain below 417 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. <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: <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 /> Claudia Xiong, Chee Nou Xiong, Pan@ Yang, Christopher Kai Xiong, Emily Xiong <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 ev <br /> 14. Completed by: <br /> Signature Title Date <br /> 5-20 Gal. <br /> Health Per Hand wash Water <br /> Sterne wlChaffing <br /> Dish <br /> Paper Hand Towels <br /> Soap dispenser <br /> Cutting Board San itizer bucket- <br /> bleach&water for <br /> Propane Stave Bleach <br /> storing wiping cloths <br /> Booth must be on <br /> n Concrete,Asphalt, <br /> Q, <br /> R +1 ff4'w' <br /> inse Water <br /> Plywood,or a Tarp. <br /> Propane Tank <br /> Soap and Water Bleach and T <br /> Garbage <br /> Can <br /> Fire Extinquisher <br /> Extra <br /> Waler <br /> Ice Cooler 5 Gal Hand was <br /> h <br /> Extra Ice Bags&Food Containers must he Wastewater Container <br /> -- stored 6 inches o8 of the ground.! <br /> EHD 16-02 Page 8 of 11 TEMP EVENT APP <br /> 08/01116 <br />