Laserfiche WebLink
SAN 10AQUIN Environmental Health <br /> r'lrr.li �' <br /> 10 1 am providing the follovnng cold temperature control for the cold holding of potentially hazardous f.nds <br /> '57(If food is used the follov.ring day,maintain below 41°F temperature) <br /> ❑Ice chests Refrigerator <br /> 'gRefricerated truck ❑Ice bath and tubs <br /> ❑Other(specify) <br /> 1 t. I am providing the folroering items within my booth for the sanitary cleaning of food preparation utensil <br /> OR Three compartment sink. <br /> ❑ Threw deep tubs (basins 6-8 inches minimum), one for soapy:eater, one for rrns;ng and one for a bleach <br /> solution(one tablespoon of bleach per gallon of vmler). <br /> ❑Detergent,bleach,and wiping cloths(cleaning towels). <br /> ❑Tub to store wiping cloths in bleach solution. <br /> 12. 1 am providing the folfo%ving for adequate hand washing facilities. but separate fmm utensil wash within my <br /> booth. <br /> i%Water supply dispenser with warm water at a minimum of 100T(i.e.5-20 gallon container with spigot). <br /> ❑Ore separate tub(bucket or basin)for the collection of rinse/wastewater, <br /> ❑Paper towels and porno-style soap container. <br /> 13 Names of responsible persons to be present in booth during all hours of operation. <br /> "Important" All food vendor booths are subject to inspection. Please make a copy of this application in <br /> preparation for this event. A copy of this checklist must be in the beo:h at all hours of <br /> preparation and operation. Return original to festival coordinator three weeks prior to <br /> this v nt. <br /> 14. Completed by_ �(a 10 3 l ZS <br /> Signature Title Date <br /> Health Permit ara LLden 4':�r <br /> S�rnc w:✓w'r4�g <br /> Dfi <br /> Sc90;..stan¢cr <br /> SW e•^w_•_ <br /> Pti�slc S!0`n 4ra:n •- ^r'S'='�� <br /> Socth m be cn <br /> C xcd.. <br /> its hdl:. <br /> Ply:�'Qc4 Cr Tarr <br /> Hrt W�Ycr>i4 I1 <br /> so,:,.WY:rrr Wyse Wwu flush an,l s;X& 1 <br /> 111 Garbage <br /> Can <br /> f rc F.tryy�tc! <br /> ,I Cs#q <br /> Wdu <br /> Ice Cooler snllr nor ., / <br /> Frh.::;.i li..�v Gl4'A C::.!.W.`tf:m.t Gt. III :':a-r x'�k•::C•Qx h<. <br /> 1 •JWilE ii_"rrt,:fury[/N.��W1� ,J <br /> M8 E.Hazelton Avenue Stocklon,California 95205 T 209 468-3420 j F 209 464-0138 j e:uu stcejt�c:; r <br /> Filb IC47 <br /> oil;!1 <br />