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SAN J O A Q U I N 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 64-Refrigeraior <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 <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, 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 /> k9-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 /> 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 /> "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 /> this eve <br /> 14. Completed by: rr s/2r <br /> nature Title Date <br /> 5-20 Gai. <br /> Hantl wash Y4tatcr <br /> Health Permit <br /> Sterno wPCnaffirx� <br /> O.Sh Pape(Hand Towels <br /> Soap drspenser <br /> San�lrzer 1hKkct• <br /> Cutting Boartl <br /> seam a watfr <br /> ��wepcg GOlhS <br /> Propane Stove B>cacn <br /> Booth mu51 on <br /> ConGlete,Asphalt, <br /> Plywood,or a Sarp. <br /> �rank <br /> Soap and ware: Panst,water BWaM and~cc Garbage <br /> Can <br /> Fre E�aurauahM <br /> F�¢ra <br /> VYatet <br /> ace Cooler S cal Hand wasp, <br /> Fera to sags s Food Cardawmarz maw he wustev.der Cont mW <br /> slo.ed 6 mows of of ma go" <br />