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A _ <br /> SA NJ OA Q [ N Environmental Health Department <br /> COUNTY <br /> Greatness grows herc. <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, main in below 41°F temperature): <br /> B"Ice chests 91Wrigerator <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 /> ree deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br /> sol on (one tablespoon of bleach per gallon of water)_ <br /> Tetergent,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 /> ❑'/Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br /> Vo/ne separate tub(bucket or basin)for the collection of rinsetwastewater. <br /> per towels and pump-style soap container. <br /> 13. Names respo s le 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. II,, <br /> 14. Completed by: <br /> Signature Title Da e <br /> sza cal. <br /> Health Permit Hand wash water <br /> steno w1Cha[fmg <br /> Ossft <br /> PaPer Hand 7oNreRs <br /> SoaC ti�pa`r�ser <br /> Cu[t np Board Sandker bucket- <br /> bleach&water for <br /> Propane Stove Bleach ! storing wiping dohs <br /> I Booth must be on <br /> Concrete,Asphalt, <br /> Plywood,or a 1 arp. <br /> Propane Tank <br /> soap and water Rinse avatar 8iearh end water Garbage <br /> Fire EiWnpedsher Can <br /> Extra <br /> water <br /> fee Cooler 5 Gal Hand wash <br /> Extra Ice Begs&Food Containers must be wastewater Container <br /> stores S 1neAes otr of see grounds <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 T 209 468-3420 F 209 464-0138 [ www.sjgov.org/ehd <br /> EHp 16-02 Page 8 of 11 TEMP EVENT APP <br /> ftfill Q114 <br />