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C O LM T Y-- <br /> 1o. I am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br /> 45"F(if food is used the following day,maintain below 41°F temperature): <br /> ❑Ice chests ❑Refrigerator <br /> ❑Refrigerated truck ❑Ice bath and tubs <br /> -VOther(specify) 1)d <br /> 11. 1 am providing the following items within my booth for the sanitary cleaning of food preparation utensil <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 1 00'F(i.e.5-20 gallon container with spigot). <br /> Q One separate tub(bucket or basin)for the collection of rinseWastewater. <br /> ❑Paper towels and pump-styfe soap container. <br /> 13. Names of respo ible persons td p event in b ath during rs of o eration: <br /> *"Important' All food vendor booths are bject to inspection. Please make a copy of this application in <br /> preparation for this even A copy of this checklist must be in the booth at ail hours of <br /> preparation and operati n. Return o`" final to festival coordinator three weeks prior to <br /> this event. <br /> 14. Completed by. <br /> Sign True <br /> Est nmist b�CM <br /> �. y o- <br /> ;� sv�r cfmrl�r :�a�rz mt�aasr:� <br /> t £� <br /> i t7"ur <br /> ice L0� }{e! F'.+.-'�+�•'+.ft+'.f +ic�J'a:rs\w..:,..:r $� r+-`=S <br /> _ tttlf .�6.aS3u"�[9?Lo <br /> 1868 E. Hazelton Avenue Stockton,California 952051 T 209 468-3420! F 209464-0138 t www.sjcehd.com <br /> EHD 16-02 page a of.1 TEMF'EVEWTAPP <br /> nrrar+� <br />