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:x' <br /> S A N = J OAQ U IN Environmental Health Department <br /> _,_CCaUiVTY -- � <br /> 10, 1 am providing the following cold temperature control for the cold holding of polerMally hazardous foods below <br /> 45"F (if food is used the following day,.maintain below 41 OF temperature): <br /> ®Ice chests ❑Refrigerator <br /> Q Refrigerated wick ❑Ice bath and tubs <br /> Other(specify) a - <br /> 11. 1 am providing the following items within any booth For the sanitary Leaning of food preparation utensil <br /> ❑Three compartment sink. <br /> OR <br /> i <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 /> 0 Detergent, bleach, and wiping cloths(cleaning towels). NIA- <br /> // � �� ��t?,�a�� <br /> 0 Tub to store wiping cloths in bleach solution. l <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 rinsetwastewater. <br /> I <br /> .0 Paper towels and pump-style soap container. <br /> 13, Names of responsible persons to be present in booth during all hours of operation: { <br /> i s rno � <br /> "Importanr• All food vendor booths are subject to inspection. Please make a copy of this application in t <br /> preparation for this event. A copy of this chec list must be in the booth at all hours of <br /> preparation and operation. Return original to festival coordinator thr weeks odor to <br /> this event <br /> 14. Completed by: . Lo <br /> ignature Title Date <br /> s2o G.i, <br /> Health Permit <br /> sr«noMcr.m+o � <br /> os <br /> ney.r rrnd Too" <br /> �D dYM�7u I <br /> �+d Saftm butbl. f <br /> b,.aeh F vwbw bt i <br /> Booth mast be on <br /> Concrete.Asphaft, <br /> RywDod,or a Tarp. <br /> PropM TAN! - - <br /> a«s•m vftw nw,..W- vim. Garbage <br /> Can <br /> � yy- vhf.r <br /> Ice Cooler <br /> [,a.x.a•a+R Roca CORGO T nrrr r. uAMft*M.Carman, <br /> Ord�rroh+.d d fh.psndr <br /> JM8 E. Hazelton Avenue I Stockton. California 952051 T 209 488.34201 F 209 464-0138 1 www.s390v orOhd <br /> GHO 16-M P020e0f rt TEMP EVENTAPP <br /> peatpatf <br />