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SANoJ0A0UIN Environmental Health Department <br /> � f COUNTY <br /> �:,�oa�, Geat�ess q�^�•s sere <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 /> 93&chests ❑ Refrigerator <br /> ❑ Refrigerated truck ❑ Ice bath and tubs <br /> ❑ Other(specify) <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 /> solutes (one tablespoon of bleach per gallon of water). <br /> @16etergent, 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 /> ater supply dispenser with warm water at a minimum of 1000F (i.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-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. P e se 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 an op ;a(te <br /> Return original to fes 'yal coordinator three weeks prior to <br /> this even '`14. Completed by: I/51g Title 15ate <br /> 5-20 Gat <br /> Hand welsh.water <br /> l-iealth Permit <br /> Stemo wrChafring <br /> CiSh dPe'Hand Ypwrels <br /> Soso dispenser . <br /> �c sannixer wcket- <br /> Cuting Boa Weach a water for <br /> storing w ipn6 cloths <br /> Blears <br /> �opane Stove <br /> A Booth must be on <br /> Concrete,Asphalt. <br /> Plywood,or a Tarp. <br /> Propane Tank <br /> x — •_ w�S , - -� -- <br /> Soap and Water Rinse Water Bleach and Water Garbage <br /> Can <br /> c Fire Erinputsller <br /> .� water <br /> Ice Cooler n 5 Gal Hand ash <br /> Extra tee gags&Fooa Conlaxters mus!oe wastewater Container <br /> stored 6 rnches at7 of the ground, <br /> 1868 E. Hazeiton Avenue Stockton, California 95205 1 T 209 468-3420 I F 209 464-0138 www.sjgov.orglehd <br /> P.n.A n(t S TEMP EVENT APP <br />