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S A N D OA Q U I N Environmental Health Department <br /> — COUr,liY— _ <br /> 10. I 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;Refrigerator <br /> maintain below 41'F temperature): <br /> ❑lw Ice chests <br /> •Refrigerated truck &ce 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 /> �hree deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br /> salusion(one tablespoon of bleach per gallon of water). <br /> ( rgent, bleach,and wiping cloths(cleaning towels). <br /> ub 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 /> 0 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 res onsibl persons to be present in booth during all hours of operation: <br /> � Cry :0- <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 aV operation. Retum_oriainal to festival coordinator three weeks prior to <br /> this event. <br /> 14. Completed by: _ (�Nml- � <br /> 9n use Title Da e <br /> s-zo Gei. <br /> Health Permit 11 <br /> Siemo wlCherfxg <br /> Dish Paper Hantl 7vrrola <br /> Soap dsperxe` <br /> Cutting Board Sanitizes <br /> adt bu&&- <br /> bie 6 wxer tar <br /> Propene S[ovo <br /> 6kad3 storing aapGq dohs <br /> Booth must he on <br /> Concrete,Asphalt, <br /> Ptfwood,or a Tarp. <br /> '-"�' Soap raid Water Rinse aver 8laach and Welor <br /> Garbage <br /> Can <br /> Weser <br /> Cice Cooler 5 Gel HOW Mesh <br /> Erlra rce sass 6 FDW CortW*fs mus!bs Wasiexater Cciftnd <br /> ttovad fi krdres adolthe graurd? <br />