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10. 1 am providing tho following cdd temperature conlr(7 for the cold holding of potentially hazardous foods below <br /> 45'F{If food is used the following day,maintain bolmv 4VF lemporatura� <br /> H too chests ❑ Refrigerator <br /> ❑ Refrigerated truck ❑ toe bath and tubs <br /> ❑Other(speafy) —_ <br /> 11. 1 am providing the following items wAthIn my booth for the sanitary caaning of food preparation utensils: <br /> ❑ Three compartment sink. <br /> OR <br /> ® Three deep tubs (basins 6-8 inches minimum), aria for soapy watm, ana for rinsing and one for a bleach <br /> solution(one tablespoon of bleach par ganon of wator). <br /> ®Detergent.bleach, and wiping cloths (cleaning Immis), <br /> ❑ Tub to store wiping cloths in bleach solelWn. <br /> 12. 1 am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br /> booth_ <br /> Water supply d[apenser►vrth warm waler al a minimum of 100'F(I e. 5-20 gallon contza nfv wrath spigot) <br /> ® Ono separate tub(bucket or basin)for the collection of rinselwaslewater. <br /> ® Paper towels and pglm-style 5w container. <br /> 13, Names of responsible persons to be present In booth during all hours of operation: <br /> Claud€s Xlong, Chea Nou XloN, Pana Yanp,Chrisinpher Kal Xlong, Emily Xiang <br /> "Important" /ill food vendor booths arc subject to inspetc6on 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. R2turn_ori9lnal to festlyal coordinate{ throe weeks prior to <br /> this a tl <br /> 14. Completed by, 5/14125 <br /> SignaturD7 TRW Data <br /> e is r� <br /> Health Permit H.Y it-I YAW <br /> 6rn*u�CJell•y <br /> Clay <br /> PKW Filial Ta-w% <br /> a1.41'{F "rQ:.sou <br /> r <br /> Gooch arias bu Oft <br /> Concrete.Asphalt <br /> Ptywood,or a Tarp <br /> Gr.�liw:Y/kar P:.nrr'OV M" 7-- <br /> llal'N illy <br /> L.rin <br /> FF�E.rrCUU�a. !- -- <br /> YvfIM �- <br /> Ice Coolor <br /> 6Rh i FCW Gw&fl r7 Haul D� N�FinwMrf G <br /> mtet ocean.prtu,s L <br /> L.0 1 nm Par'e F]a1 11 TE►P V xr AFP <br /> Wo 1118 <br />