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SAN JOAMN Environmental Health Department <br /> I � I <br /> 10. 1 am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br /> 45eF (if food is used the following day, maintain below 41°F temperature): <br /> ® Ice chests H Refrigerator <br /> H Refrigerated truck H Ice bath and tubs <br /> H Other(specify) <br /> 11, 1 am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br /> H 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 /> 0 Detergent,bleach, and wiping cloths(cleaning towels). <br /> M 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 /> Q 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 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 event. <br /> 14. Completed by A016 &� COORDINATOR 8 FEB Ma <br /> Signature Title Date <br /> 540 Gal <br /> Health Permit Hand wash Water <br /> S lerno w/ChafB <br /> D,sh Paper Hand Towels <br /> Soap dapenaer <br /> Cuttiq Board SaNitor WON- <br /> bleach 6 water for <br /> Propane Slave Bleach stonnq wining oaths <br /> Booth must be on <br /> O Concrete,Asphalt, <br /> Plywood,ar a Tarp. <br /> Propane Tank <br /> Soap and water Rise Water Bleach and worm Garbage <br /> Can <br /> Fire Ednquisher <br /> E�Ire <br /> Walar <br /> (11-ce Cooler _ 5Gal Hard wash <br /> fFatra Ice flags 6 rood Confamen must be Waslewafer Container <br /> stored 6 inches off of the grounds <br /> 1868 F. Hazelton Avenue I 5iocklon, California 95205 l T 209 x168-31420 1 F 209•16,1-0138 I www.sjcdlid.com <br /> EHD 16-02 Page 8 of 11 TEMP EVENT APP <br /> D7f3117 <br />