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`i <br /> SA NUJ OA Q U I N Environmental Health Department <br /> COUNTY <br /> Greatness Greatness grows here. <br /> 10. 1 am providing the following cold temperature contro[for the cold holding of potentially hazardous foods below <br /> 45°F(if food is used the following day,maintain below 41°F to rature): <br /> El Ice chests El Refrigerator <br /> ❑Refrigerated truck ❑Ice bath and tubs 1' tQ <br /> ❑Other(spay) <br /> 11. 1 and providing the following items/gallon <br /> for the sanitary cleaning of food preparation utensil <br /> ❑Three compartment sink. <br /> OR <br /> ❑ Three deep tubs (basins 6-8 um), one for soapy water, one for rinsing and one for a bleach <br /> solution(one tablespoon of bleac water). <br /> ❑Detergent,bleach,and wipingg towels). <br /> Tub to store wiping cloths in b . <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(i.e.5-20 gallon container with spigot). <br /> One separate tub(bucket or basin)for the collection of rinselwastewater. <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. 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'I lion. Return original-to festival coordinator three weeks orlor to <br /> this eventL <br /> ��� Z1 r <br /> 14. Completed by: (� Z <br /> ignature Title Date <br /> &20 cal, <br /> Health Permit Hmrdwashwaw <br /> sumo�eChat� <br /> r�tr <br /> vapor nand Toweh <br /> soap dbpe� <br /> [tang award sadtlza txtaet. <br /> �kadr d water for <br /> Prop"Stove 8k°rJi atodnp pane <br /> Booth must be on <br /> Concrete,AsphatL <br /> Plywood,or a Tarp, <br /> 1 <br /> t soap and water Rine water akoc8&M Water Garbage <br /> Can <br /> Fire ExftAtxr <br /> EsVa <br /> �. 1Nalpr <br /> Ice Cooler sU"and Wuh <br /> EM ko an"6 Food IbnhYNn mus!De ���� <br /> +toed d hdtaa oRar fM poundf <br /> 1868 E. Hazelton Avenue I Stockton,CalHornla 952051 T 209 408=34201 F 209 464-0138 1 www.sjgov.org/ehd <br /> EHO 1642 Pape a of ll TEMP EVEM AM <br /> 071o1J2= <br /> CaznScanner <br />