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SAN 10AQUIN Environmental Health Department <br /> 10 1 aT prO%-fdrng the following colt temperature control for the cokl holding of pafentially hazardous Iv-As to-+ <br /> 4!*F (it food is used the f;,4iowing day_ masetaan below 41`F temperature) <br /> KIce chests 0 Refrx#eralor <br /> Refr►geratea truck ❑Ice bath and tugs <br /> Other ispecl i <br /> 1 i 1 am provrd:ng V*fotlowrng ?,eras within my booth for the sanitary deanrng of fond preparation ui:ensi <br /> a Three compartment sin. <br /> OR <br /> ree deep tubs (basins 64 inches m n€mum), one for soppy water. one for rinsing and one for a bleach <br /> eon (one tablespoon of bleach per gallon of water) <br /> C Detergent tleach and wapuN cloths (cleaning towels). <br /> Tub to store wrpang cloths an bleach solibon <br /> 12. 1 am providing the f-)ilowang for adequate hand was" facilities. but separate from utensil wash vwrthn r'•+'r <br /> boo'h <br /> S V.ater supply arspenser with warm water at a min mum of 100°F (r e.5-20 gallon container with spigot) <br /> ,52 One separate tub(bucket or basin)for the cotlection of nnsetwastewater. <br /> (R Paper towel and cumr-st,rle soap contaviner <br /> 13. Names of respoTable persons to be presort in booth during all hours of operation <br /> Ij <br /> —Important" A9 food ,vnror booths are subject to inspection Please rnal,.e a copy of In appbtalaon ;r <br /> preparation for this event A copy of this checklist must be ,n the boo'h at all hours e <br /> preparation and o Re um original to festival coordinator three weeks prior to <br /> this event. _-- <br /> 14. Completed by ' <br /> —ll�Ul1L��- <br /> Signaturf Title Date <br /> Neafth Permit <br /> 11 i <br /> l3iJc�i7s�uS,i t�Cs^- <br /> Cc.�cxear �t»"tadt <br /> 71 F tywr c7 v a's <br /> Ga:•yW <br /> Car <br /> r <br /> tbGB F +lszt,e i Aivenue ( Storiton Gatifomrs 95205 I T 209 468,1A20 1 F 209 4e.4.01,18 I www swv d <br /> Enfy�r,.s:3 Psi.t�#tt TEMP VAN'APO <br /> oarrw t 9 <br />