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SANdQAQUiN Environmental Health Department <br /> —COUNTY - <br /> iireotnes,ti <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 41aF temperature): <br /> ❑ toe chests ❑ Refrigerator <br /> ❑Refrigerated truck ❑ Ice bath and tubs <br /> E ter(specify) C60 &1C7 S' N.S,-/-- K/ r/'t°W — 7 C e <br /> 11. t 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 /> sot�rtion(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 /> LC 4ater supply dispenser with warm water at a minimum of 100'F(i.e.5-20 gallon container with spigot). <br /> [ne parate tub(bucket or basin)for the collection of r nselwastewater. <br /> towels and pump-style soap container. <br /> 13 games 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 it <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 /> this vent. ��� <br /> 14_ Completed by: �l _ 12 12- <br /> �✓� 2_ <br /> Signature Title Dai <br /> 5-20 Gal. <br /> Health Permit Hand Was"wow <br /> Starcw r'Cna!fing <br /> D fi <br /> Pft"IW4 Taft <br /> Sasp 980m+5er <br /> C+ar9 6aare Sa Vv ou &. <br /> sodcp&+"for <br /> �rupara Sw.a bleach slannq..+pry_DUm <br /> Boom must W on <br /> Concrete,Asphalt. <br /> 4 Plywaod,OT a Tarp. <br /> Prow"ism <br /> B"P and Waif rtv+aa Wwor 010ach&W WaWr C.arm9a <br /> r Can <br /> If/L—+V�ll Fwa <br /> WaWr <br /> rice Coole <br /> s aal nrrW.WJ, <br /> EFoa tM"go 6 Food Carurrw 3 m.ru u Wnlawelrr Gcurlauwr <br /> aenrw a i�aa ON of Vta y awwe <br /> 1868 E. Hazelton Avenue I Stockton,California 95205 T 209 468-3420 F 209 464-0138 1 www,sjgov.org/ehd <br /> EHD 1&02 Pepe 8 ar 11 TI_MP EVENT AP <br /> OV0112025 <br />