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SAN -JOAQUIN Environmental Health Department <br /> C:-'0 U N'I Y <br /> 10. 1 am providing the following cold temperature control for the cold holding of potentially hazardous roads below <br /> 451F(if food is used the following day,maintain below 41 OF temperature): <br /> [ilce chests ❑ Refrigerator <br /> Refrigerated truck [.J Ice bath and tubs <br /> [.-Other(speci(y)_ ----- —� -�- – <br /> 11. 1 a providing the following items within my booth for the sanitary cleaning of food preparation utensil <br /> [ hree compartment sink. <br /> OR <br /> ❑ 'l-hrae 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 /> [J Detergent,bleach,and wiping cloths(cleaning towels). <br /> L_J'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 /> [�ater supply dispenser with warm water at a minimum of 100°F(i.e.5-20 gallon container with spigot). <br /> LJ one separate tub(bucket or basin)for the collection of rinse/wastewater. <br /> -aper .towels and pump-style soap container. <br /> 13, Names of respo si le person,to„bApresent in booth during all hours of operation: <br /> "'important" All food vendor booths aro subject to f this <br /> �scclheck!list musPlease l�be In the boofltof this <br /> at all applIhotuors of <br /> in <br /> preparation for this event. A copy <br /> preparation and operation. Return orl anal to festival coordinator three weeks I prior to <br /> this cv n ,�i t IV IV e-� AZ-1, <br /> 14. Completed by: _�___�__ _ . Title —bate <br /> Signature _ <br /> r-xo cbl. <br /> , .'J"nS;<pylf, nana Nmsh Watm <br /> I lealth Permit � ------"�--- �—-------- I�__r___._.-- <br /> ---... -. ..+--J- Slmrrowlfnnflilp ..__ •--- I I�porTltrrW"fawda .. <br /> IAGr I ..W I <br /> futtln011orcd� - Mandl d Wal Alar <br /> I I'rnprYlo S(ma <br /> 11001h mist bo ort <br /> Concrrto./lspttali, <br /> ------ — - -- - ( 1,lywoml, r a <br /> --- <br /> X <br /> //- 11TH <br /> fwjwa TM* <br /> ---'— <br /> SoapwAWAV Rktsowlw IIWad1ruWVJntar Garbaga <br /> _ 1.�__.._....._...._. —•--_..___.. <br /> Fka 1'><Ilnprddmr <br /> �� .........,..-_. w.— <br /> (,r,r,a'� �'"ai :,�l .�r4 ' d !'t aCnl Iland watt <br /> I(�.I.: Cooler <br /> _ •-`f".`'"��.'•,- � � •�:`• .• Waatewrt[nr 6nnl�dnnr --__ <br /> I xfn>A.'o naris rand Carltarra+s <br /> afurad 6lncfmc n7l nr 160 prornxrf ' ' <br /> 1868 I-. I lazoltnn Aventle I Stockton, Caiil'orrzfa 9'.rI o� f i�4)4GE3 34711 J f= 209 464-01Mwww.slii.M�di vr+�l Alr <br /> qn � <br /> I:III)low <br /> 07131 t r <br />