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- SANJOAQUIN Environmental Health Department <br /> t• -- COUNTY- <br /> Grcotncss grows herr <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 aF temperature): <br /> S 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 /> ❑Three compartment sink. <br /> OR ff 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 /> 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 rinse/wastewater. <br /> Paper towels and um s e 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 /> 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 riot to <br /> this event. n <br /> 14. Completed by Title Date <br /> 5-2t1 nal <br /> Hand,roan weier <br /> Health Permit ster„owrchona <br /> soap <br /> [A��U <br /> &eBCll <br /> $ltwe <br /> Booth must tie on <br /> Concrete,Asph8lt, <br /> plywood,or a Tarp. <br /> Proparre Tw* <br /> soap.rd WaW Fame Wets! gh6chendWWr Gaft) w <br /> Can <br /> RM EAN-00W Ewa <br /> 5 Gel tlmd rash <br /> ice Cooler W��Co <br /> eaw s Food canri•»ra n.ut Oa <br /> eKaed a a on of tAe wa+xm <br /> 1 B68 E. Hazelton Avenue stockton,California 952051 a 209 468-3420 1 F 209 464-0138 1 www.sigov.11 TEMP r=rgletTdd <br /> APP <br /> r=Ho 16-02 <br /> 0710112024 <br />