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Title <br />i1L / OW> ?4,0 s--- <br />Date <br />.5-24 Us <br />rtvc rzei Aerwr <br />I Parer Flaidlltasels <br />.laziesar <br />de ad, IL mew ler <br />snc rrG aping della <br />Sap -eripertaer <br />Booth rnwt be on <br />Concrete A.sphalt. <br />,-"veond nr a tarp <br /> 1 <br />l <br />ice Cooler <br />Sas: <br />Coo la. awp Riad Casonleerz mar be <br />immured slew of at V. <br />SANAOAQUIN <br />,t COUNTY-- . aSistir <br />4, k i reritiness grow; herr <br />Environmental Health Department <br />10_ I am providing the following cold temperature controlfor the cold holding of potentially hazardous foods below <br />45'F I it focC is used the following day. maintain below 41"F temperature). <br />0 Ice chests 04iefngera1cr <br />O Refngerated truck Gdice bath and tubs <br />0 Other (specify( <br />11. I am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br />0 Three compartment si nk <br />OR <br />. <br />tt*Three deep tubs (basins 6-8 inches minimum). one for soapy water. one for nnsing and one for a bleach <br />n one tablespoon of bleach per gaHon of wate0. <br />tergent. bleach, and wiping cloths (cleaning towels). <br />uti to store wiping cloths in bleat solution. <br /> <br />12_ I am prowaing the following fix adequate hand washing facilities, but separate from utensil wash within my <br />tooth. <br />(..14/ater supply dispenser with warm water at a minimum of liDO -F (ie. 5-20 gallon container with spigoti_ <br />i4.One separate tub 'bucket or Pas n i for the collection ot rinseVastewater. <br />per towels and pump-style soap contaner. <br /> <br />13 Names of responsible persons to be present in tooth dunng all hours of operation <br />c-0-C-1) LZI---1" 13 I 9 <br />All food vendor booths are subiect to inspection. Please rnake 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 />1868 E. Hazetton Avenue I Stockton, Cairtcrnia 95205 I T 209 468-3420 I F 209 464-0138 I wviniv.smov.orgiehd <br />END 16-fa Piro ad 11 TEMP EVENT APP <br />OT,111.2114 <br />...