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IT) SAN:JOAQUIN <br />C•UNTY— <br />•• Groutrcs.: 5ruv.3 <br />Environmental Health Department <br />I C sar.,..,7 • <br />Fitr^t ,f , <br />.•••••• <br />Garnaco <br />Can <br />f este: csf a/ Iry p•M <br />Health Permit S.. <br />St.1 <br />e•lc • <br />w 11 =1"z. <br />Booth nn.s.: to on <br />Corcre:a, Asonalt. <br />Plywao.s. or a Tara <br />R EC-003 <br />1 <br /> <br />10. <br /> <br /> I am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br />e <br />CF (if food is used the followin , maintain below 41°F temperature): <br />ce chests eingerator <br />trigeratcd truck cc bath and tubs <br />her (specify) <br />providing the folloveng items within my booth for the sanitary c'eaning of food preparation utensi' <br />hree compartment sink. <br />Op <br />hree deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br />tron (one tablespoon of bleach per gal:on of water). <br />ergent, bleach, and wiping cloths (cleaning towels). <br />ub to store wiping cloths in bleach solution. <br />I am providing the following for adequate hand washing facillies, but separate from utensil wash 'within my <br />booth: <br />TIVater supply dispenser with warm water al a minmum of 100°F (i.e. 5-20 gallon container with spigot). <br />TPrie separate tub (bucket or basin) for the collection of rinse/wastewater. <br />(1)Vr \\ SAylse-- <br />Ftaper tow6s and WV-510e soap conta:ner. <br />Names of responsible persons to be fxesecrt in booth during all hours of operation: <br />' <br />"Important — food vendor booths are subject to inspection. Please make a copy of this application in <br />preparation for this evcnt. A copy of this checklist must be in the booth at all hours o' <br />preparation and operation. Retufn oripinal to festival coordinator three weeks prior to <br />"1 /17/21 SUBMIT <br />Dale <br />1868 E. Fiazelton Aven,x Stockton, Calfornia 95205 T 209 468-3420 F 209 464-0136 I Wriv..Sigov.org •tha <br />MD • 5 02 P3(1050111 MAP cvEN7- APP <br />event. . -c-rN 14. Completed by: \ ..) <br />Signature <br />1-) y- <br />Title <br />Scanned with CamScanner