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. , <br /> ^ <br /> � � � } � � h | W ����`���00��nt�K ����&th ��e��aotr�ent <br /> � " ^ . � �,"� = . , . " <br /> , . <br /> 10. | am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br /> 45,F(if food ia used the following day, maintain below 41"Fb*mper@iuna): <br /> Ice chests Refrige ze"l <br /> Refrigerated truck [] Ice bath and tubs <br /> Other(spec|fy) <br /> 11. | am providing the following items within my booth for the sanitary cleaning offood preparation utensil <br /> ORhJ Three compo�mwntsink. <br /> r` <br /> Fl Three deep tubs (basins 6~8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br /> solution (one tablespoon 0f bleach per gallon ofVvator). <br /> Dohergent, bleach, and wiping cloths(cleaning towa|a). <br /> i] Tub bo store wiping cloths in bleach solution. <br /> 12. | am providing the following for adequate hand washing facilities, but separate from ubannU wash within my <br /> booth: <br /> Water supply dispenser with warm water at a minimum of 100'F(i.e. 5-20 gallon container with spigot). <br /> J��� Dneoeperotetub(buoketorbamin)fordhecuUecUonofhnaa/waotewabar. <br /> �JPaper towels and container. <br /> 13. Names of responsible persons to be presentin booth during all hours ofoperation: <br /> "Important" All food vendor booths are subject to inspection. Please make a copy of this application in <br /> preparation for this �vent. A copy of this checklist must be in the booth at all hours of <br /> 14. Completed by: � <br /> Signature Title Date <br /> Health Perml Sterno W/ChaffiN Hand wash Water <br /> Dish D <br /> Cutting 8 a Sanitize <br /> Sisson storing wiping cloths <br /> Booth nlust be on <br /> nK <br /> Soap and Water Rinse Water Bleaoh and Water <br /> Garbage <br /> Can <br /> Fire ExtinnuE�j <br /> I Ice Cooler <br /> 5 Gal Hand wash <br /> wastewater Container <br /> Extra No Bags&Food Containers mus(be <br /> 188OE. Hazeiton Avenue 1 Stockton, California 85205 T 209408-3420 F 209464-0138 1 Www,ejcohd.com <br /> s*o1s-0u Page um11 TEMP EVENT^pp <br />