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S A N of 0 A U I N <br /> - - `� Q Environmental Health Department <br /> 1. rye`• ,- off;�f SS �-'n: <br /> 10. 1 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 /> [ 'ce chests ❑ Refngerator <br /> /❑ Refrigerated truck ❑ {ce bath and tubs <br /> ❑ Other(specify) <br /> 1 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 100°F 0.e 5-20 gallon container with spigot). <br /> One separate tub (bucket or basin) for the collection of rinse/wastewater, <br /> Paper towels and pump-st,4e 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 booth at all hours of <br /> preparation and operation. Return original to festival coordinator three weeks prior to <br /> this event. <br /> 14. Completed by: <br /> Signature Title Date <br /> Health Permit <br /> Sterne wlCralt^g <br /> 5h <br /> Raper Hang Tawe15 <br /> $ciao Qlspersor <br /> Cutb%Boars Sanrazer ouckel- <br /> Neach d water for <br /> Propane Slone &each slonng wlgng Corns <br /> $oplll rrluSt be On <br /> Concrete,Aspnait, <br /> f Plywood,or a Tarp. <br /> P <br /> ropane Tank �: '1 .. _—^�_ r-s3"k2�. ---1-`tY---=pan s< - Yc <br /> ,r soap anc Wales Rinse water Bleac and water Garbage <br /> Can <br /> t Frre Extlnpuishee <br /> + E rrtra <br /> C Water <br /> Ice Cooler Val Ha.c m%t* <br /> L!n _11__ <br /> a Sags6 Fooa Ccr:ta,ne,7s xrcroa fi riches OF cf me grow: <br /> 1868 E. Hazelton Avenue l Stockton, Califomia 95205 l T 209 468-3420 F 209 464-0138 1 www.sjgov.org/ehd <br /> ^ _Q^'" TEMP EVENT APP <br />