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SAN.:JDAQUIN Environmental Health Department <br /> i UNTY ._...... <br /> 0. I am t�ro�iciiitq tl a fof ot4ing Cold tentperatur©rantrai for the cold holding of potentially f azarrlous foods below <br /> 45nF(ff food is 4ued fnllciw;ng day, rnr4ntain below 41"F temparatt re), <br /> [ Ice chLs4s El Refrigerator <br /> [rJ Refrineiater Prue; [�lue bath and tubs <br /> ��. t any p avUng the follb%v ng items within my heath for the sanitary cleaning of food preparation utensil <br /> [] Three cornpaitrnerttsink. <br /> OR <br /> ( Three dr_-ep tubs (basins 6-£ inches minimum), one for soapy water, ono for nnslnq and rrie fof a h[e2e� <br /> solution(one ta"blespocn Of Ueadh par gallon of Water). <br /> Lj Detergent,Mead).and wiping cloths(cleaning towels), <br /> Tub 40 store wiping cloths in bleacft solullcn. <br /> ir. 1 am prmAding the following for adaauate hand washing facilities, bGt separate from utensil wash within my <br /> hrsath: <br /> ❑Watersuppty dispi5nserwithvarmwaterat,a miliirnu�n of 100�F i~i.e.5 20 galk)n Gontairtervrifh spigot), <br /> Dne separate tub(bucketor basin)forthe colfection of rinseAvastawater. <br /> Paper tmhols arid�u?npr_sh;.le soap t ontm Tier. <br /> Names of responsible persons to be pesert in haogi duri-ig:III hours ofopesatirn: <br /> ^ Important— All fad uendl7r booths �r,.iE solo sct tr} Please make a IMPY of this application in <br /> preparafion `.or this eve!-it. A copy of this checklist must be in the boafh at 41 houm of <br /> preoaratscn.and �peration. Re LI M..orLqinai to festival coordinator,three weeks prior to <br /> this eve <br /> 14_ Completed by- i <br /> T"itfe- Date <br /> f L/ 1 1 <br /> ! t-i2at[h Per1r:� "� 1�na nz�:wr�r I <br /> S�C�owl�tiarrvn, I .—J .. <br /> ✓f �sXL.TCf fj�7".� <br /> 4 Do"mmtba art <br /> f - r +onaele,ASgHalt <br /> spa rTurh h�inr hl1r�.1h�w ��Y�p,ArvSYYr:� - -- <br /> j 11 <br /> ? �trg F,ir.Vrp'�lafwr - Call <br /> �y <br /> Ice Cooler _ -- — — <br /> ( F.xfI9f3r§{1eQ}�xffcri�l�az�pus1 <br /> xe V,ina+�W+gertcrcsia:nr <br /> '... sneq�I�,�i;e_a+rorjkfrglFurigl. __ ��� <br /> 'f868 . Hazettcn k>rert le l Sty tin,G lliforit <br /> > ;[i ia 95201 T 209 g6Q-342431 F: 20.4 46 -0.1 8 � r rr.sjc�fitd.cr <br /> �sxi <br /> 07;''li7 .R�Ipp?I'�I i1 - TEYrr jar A?F' ...'p <br />