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SAN JOAUUIN Environmental Health Department <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, maintain below 41°F temperature): <br /> ❑ Ice 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 /> Z Three compartment sink. <br /> OR <br /> ❑ Three deep tubs (basins 6-t3 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 /> 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 responsible persons to be present in boot 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 /> is eve t. II , <br /> 14. Completed by. l <br /> Signature Title Date <br /> 5.20 Gal- <br /> Health Permit Hand wash water <br /> Stems wlcnefretg <br /> Oisn <br /> Pacer!land Towele <br /> Soso tl�acenaar <br /> C,A2ry Board sanduer burket- <br /> x.a 8 waler rot <br /> Frotrane Sl�e 9lcech slornq xnp, rJotrs <br /> Booth must be on <br /> Concrete.Asphalt, <br /> Plywood,or a Taro. <br /> P-ooens Tana <br /> soae and r:ete+ a nan water ekaU end water Garbage <br /> Can <br /> FrC ESSirvdµiahar <br /> Extra <br /> were• <br /> Ice Cooler . 5G91rianawsah <br /> Exrm rce Bogs d Faod containers mast be Wastewater Contester <br /> alined s ruches e!of me prOerrad' <br /> 1866 F Hazelton Avenue I Stockton, California 95205 J T 209 468-3420 1 F 209 464-0138 1 www.s1gov.orgreho <br /> EHO 1"2 Page a o1 f 1 TEMP EVENT APP <br /> 05119119 <br />