Laserfiche WebLink
SAN J QA Q U I N Environmental Health Department <br /> i r ..,.. <br /> 10. 1 am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br /> 45aF(if food is used the following day, maintain below 41'F temperature): <br /> ❑ 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 <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 /> ❑Water supply dispenser with warm water at a minimum of 100aF (i.e. 5-20 gallon container with spigot). <br /> [I 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. Y Completed b <br /> p _ c1•_ _r_l �_ r - - ii c _. t - i <br /> Signature Title Date <br /> z , <br /> 520 Gal. <br /> Health Permit Hand wa-h Water <br /> Sterne wlGhntlirtg <br /> Dish <br /> Paper Mand TpWats <br /> Soap dlspvn6nr <br /> Ctdurgl Etoard Sanihzer bucket. <br /> eluach b water for <br /> Prppanp Slaw Hloach storing vaping doth- <br /> Booth rrltlSt he on <br /> Q Concrete,Asphalt, <br /> ;a Plywood,or a Tarp. <br /> Propane Tank <br /> Shop and Wamr Rima wales Bleach and Water Garbage <br /> Can <br /> Fire Etningutsher <br /> 6dra <br /> Water <br /> I <br /> Ice Cooler I 5Gal Marx?wash <br /> _ Extra ke 6ag3 6 Fowl canlaum rnum 8e W astexator Cm4ainnr <br /> stated 6,hehas off of the grorerrff <br /> 1868 E-. Hazelton Avenue f Stocklon, California 95205 T 209468-34201 F 209464-0138 J www.sjgov.org/ehd <br /> RID 16-02 Page 8 of 11 TEMP EVENT APP <br /> 06129f2023 <br />