Laserfiche WebLink
S A N J O A Q U ! N Environmental Health Department <br /> a1 I <br /> 10 I am providing the following cold temperature control for the cold holding of potentially hazardous foods tvitwv <br /> 45"F iit food is used the following day, maintain below 41'F temperature) <br /> $1ljce chests ❑ Refrigerator <br /> C Refrigerated truck ❑ ice bath and tubs <br /> ❑Other(specily) <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 bleact, <br /> ut*n lone 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 wrthin my <br /> booth <br /> water supply dispenser with warm water at a minimum of 100'F (i.e 5.20 gallon container will,spigot) <br /> One Separate tub (bucket or basin)for the collection of rinse/wastewater. <br /> Paper towels and pump•slyle snag contatr+er <br /> 3 Names of responsible persons to be present in booth during all hours of operation <br /> -:�Ak,eA ---7,00 cr U2 <br /> "Important" All food vendor booths are subject lu inspection. Please make a copy of this appl,catton in <br /> preparation for this event A copy of this checklist must be in the tooth at all hours of <br /> preparation and operation. Return oritxinai to festival coordinator three weeks prior to <br /> this event. ll <br /> 14, Completed by- —tea__v-kg= 1 � � w r19L,L <br /> Signature Title Date <br /> Health Permit <br /> ia.+n r.0 n.�•^u <br /> u•,I <br /> I Sly tl•7v..cr -- <br /> %'-s..oe:�.... '- lllnrl � '� j� '•hw�p wi•w Win'•_ - <br /> B muSI be or <br /> • _ — ( � r �I � PtylNox.0'a Taro <br /> � I I�--IIr � ��• - <br /> Stipp aril:l W/t '.JM• I Ir1 GarbageCan <br /> �---_ -.1 <br /> (Ice Cooley a .. n• <br /> ku`�kv/1op.alard�A>wA1•\In..:u � �ss�.... ...• <br /> 18b8 E Hazelton Avenue I SIOCKton, Gal iom-, T <br /> FHDtb-02 If aOl I rrpwf,i'�t .��' ' <br /> iwvi%14 <br />