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r p' <br /> r" <br /> SA NJ OAQ U I N Environmental Health Department <br /> COU NTY <br /> Greatness grans bore. <br /> 10. l am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br /> � F(if food is used the following day,maintain below 41 aF temperature): <br /> [1 lce 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 /> 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 /> f Water supply dispenser with warm water at a minimum of 100°F(Le_5-20 gallon container with spigot). <br /> done separate tub(bucket or basin)for the collection of rinselwastewater. <br /> M Paper towels and pumo-style soap container. <br /> 13. Names of responsible persons to be present in booth during all hours of operation: <br /> r <br /> "*Important" A11 food vendor booths are subject to inspection. Please make a copy of this application in <br /> I preparation for this event A oopy of this checklist must be in the booth at all hours of <br /> preparation and tion. Retum orininal to festival coordinator three weeks prior to <br /> I this event <br /> 14. Completed by: \N '�S <br /> ignature Title date, <br /> 5-20 Gal. <br /> Health Permlt VHne-ndh water <br /> i 6temo w1(Xrairmg <br /> Paper Hand Towels <br /> r 6oeP tllapenser <br /> CUt1sr7 $arh& ter1- <br /> bleach 6 waater for <br /> r Bleach stodng wiping ddhe <br /> r Propane Salve <br /> r <br /> I Booth must be on <br /> Concrete. <br /> ywood,or a Plywood, Tarp. <br /> Propane Tardy <br /> I % soap and water Horse water steamy and water Garbage <br /> t <br /> Can <br /> {. Foe E�dhmutshar <br /> t <br /> 6Gal Hand wash <br /> gs' E-"Ace fla 6 Food Coate..masf be Wastewater Cor t drMt <br /> dared 6 7+4tras orrW Me grome <br /> I <br /> 4868 F. Hazelton Avenue I Stockton,California 95205 T 209 468-3420> F 209 464-0138 { www.sjgov.orglehd <br /> EHD 16-02 Page 8 of 11 TEMP EVENT APP <br /> a7rov2o2s <br /> I <br />