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SANhJOAQUIN Environmental Health Department <br /> C 0 lir-4 <br /> i <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 41aF temperature): <br /> ❑ Ice chests <�N,gefrigerator <br /> ❑Refrigerated truck ❑Ice bath and tubs <br /> ❑Other(specify) <br /> 11. +qp 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 /> I"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 /> KPaper towels and pump-style soap container, <br /> 13. Names of responsible Dersons.to be present in booth during all hours of operation: <br /> rTi4— <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 o ati Return original to festival coordinator three weeks prior to <br /> this eve .1 <br /> 14. Completed by: ��YNz ! 23 <br /> Si at re Title Dat <br /> sza Gal. <br /> Health Permit Hand wash Watm <br /> S+emd wG.afhrg <br /> paper Nand Towers <br /> Svep Wspansar <br /> C.?Ur+�aaaro Sanvzertw M- <br /> doaM d orator rot <br /> &oa[h $tang vnpvy cbms <br /> Propane Saa <br /> Booth must be on <br /> Concrete.Asphalt, <br /> Plywood,or a Tarp. <br /> Propane lino ..-- .._... <br /> SvaP antl Watw Rinse W810r Bhrach and water Garbage <br /> Can <br /> Fva Frrunpmsher <br /> Extra <br /> Walvr <br /> i <br /> Ice Cooler 4Gat Hand sash <br /> Faha lCa BaQf a Fovrr Cwtmnera mutt fx Waslewalvr Contmner <br /> afand 6 erpfra off of fha VMu0e1 <br /> 1868 F.Hazelton Avenue Stockton,California 95205 j T 209 468-3420 I F 209 464-0138 I www.sjgov.orglehd <br /> £HO 16-02 Page 8 n1 11 TEMP EVENT APP <br /> }} 0&19119 <br />