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SAN JOAQUIN Environmental Health Department <br /> 10 1 am providing the following COW temperature control for the cold holding of potentially hazardous foods below <br /> 45'F(if food Is used the folkymng day maintain be ow 41'F temperature) <br /> ❑Ice chests ❑Refngeratoi <br /> ❑Refrigerated truck Ice bath and tubs <br /> Other(specrty)_� ---- <br /> t 1 I am providing the following items within my booth for the sanitary Leaning of food preparat&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,beach 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 /> Wafer supply dispenser wrath warm water a1 a minimum of 100'F(i e.5-20 gallon container wnth spigot). <br /> One separate tub(bucket or basin),for the collecbon of nnselwastewater <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 /> preparatson for this event A copy of this checklist must be In the booth at all hours of <br /> preparation and operation Retum original to festival coordinator three weeks prior to <br /> this event. <br /> 14. Completed by <br /> Signature Cam— Title Date <br /> smy <br /> Health Permit rn�f�+.nwr <br /> SLK':1:M•yr <br /> wC•i+.�b <br /> lMa«r ai r q pry dcru <br /> Booth must be on <br /> 11 1 1 Concrete Asphalt <br /> Pry.wppd or @ Tarp <br /> .M1.ter.1 r. <br /> 4Ju rr.h ray 9nr wale. s...,w ww., GarNW <br /> Can <br /> lore <br /> wry <br /> I <br /> Ice Cooler srw�.wv.wn <br /> Ewe to Ailp 4 Mia GAYA a wM r WewWOW <br /> wiaw i rt*—of d a go— <br /> 166e E t•1Rtiefton Avenue 1 SVx*(on.[a4 omia D5M I T 209 4W34201 F 209 464-0130 I www. saw.00m <br /> E'rP+6AV papa 6 d t r TEMP EVENT APP <br /> Brat' <br />