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S A N J O A Q U I N Environmental Health Department <br /> COUN- Y' <br /> 10. 1 am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br /> 45OF (if food is used the following day, maintain below 41°F temperature). <br /> E,ice chests Refrigerator <br /> ,refrigerated truck ❑ lee bath and tubs <br /> ❑ Other(specify) <br /> 11. lam roviding the following items within my booth for the sanitary cleaning of food preparation utensil <br /> hree compartment sink. <br /> OR water, one for rinsing and one for a bleach <br /> ❑ Three deep tubs (basins 6-8 inches minimum), one for soapy <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 /> -Vlfater 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 rinselwastewater. <br /> ❑ Paper towels and pump-5tyle soa2 container <br /> 13. Names of responsible persons to be present in booth during all hours of operation. <br /> of this a lication in <br /> "irnportanY• Ali food vendor booths are subject to inspection. Please make a copy pp <br /> preparation for this event_ A copy of this checklist must be in the booth at all hours of <br /> preparation ration. Return original to festival coordinator three weeks od <br /> or to <br /> thi 8 '1 Pet- <br /> 14. Completed by: Signature Title Date <br /> 5."� Go <br /> Nrk1 ra7h WwIM <br /> Health Kermit E�] <br /> so.c wvMW <br /> 5�n.zar t+Y.1N <br /> t4**&A. 'a <br /> Gs�+o sera <br /> $wwU+ <br /> Propww�D'~ $ooth must be on <br /> Cortuele.pypha4. <br /> Plywood.or a Tarp. <br /> hoo 'e ire SW ane Yvatr RXUM 1�aw Garbage <br /> Can <br /> Ft+Ctf - rxar. <br /> W�l�r <br /> i;z(4 <br /> SCaYMW'dwalh <br /> oto aws <br /> . <br /> T 209i 468-3420 t F 209 4M.0138 I wwwr a T��e d <br /> Avon l Stc�k�'Cailforrtla 952 p� <br /> l-, KaZelton A <br />