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7124/23, 1:55 PM 20230426_120724.jp9 <br /> S A N° O A Q U IN Environmental Health Department <br /> 10. 1 am providing the following cold temrtpfaturo control for the cold holding of potentially_ hazardous foods below <br /> 45"F(it food is used the following day,maintain below 41"F temperature): <br /> ❑Ice chests XRefngerafnr <br /> ❑Refngerafed truck ❑ Ice bath and tllbs <br /> ❑Other(specifyl <br /> 11. 1 aril providing the tollowing items within my booth for the sanitary cleaning of food preparation utensil <br /> OR )`L%Thme compartment sink. <br /> El Three: deep tubs (basins 6.8 inches minimum), one for soapy water, one for rinsing and one fat a bleach <br /> solution(one tablespoon of bleach per gallon of water). <br /> ❑Detergent.bleach,and wiping cloths(cleaning towels). <br /> [1 Tub to store wiping cloths in bleach solution. <br /> 12. 1 am pro\nding 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 100°F(i.e.5.20 gallon container with spagot). <br /> ❑One separate tub(bucket or basin)for the collection of rinselwasiewater. <br /> D Paper towels and pump-style soap container. / � i �y4i 1gr- <br /> 13. Blames 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 applicatton to <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 ev8 <br /> 14. Completed by: <br /> ignature Title Date <br /> _o chi <br /> i"lealth Permit sari l waer ware <br /> s,orW wrchamn� <br /> aeh P�c"rr SKr rN+Mr4 <br /> SfaV Rispenyor �— <br /> (:uunp Fwmp sa,.n;er o4ce. <br /> Maach 6 wale+kx <br /> QfprJJfN$TM nlyapF +4vu,y eyxr4j,ivh <br /> fkwlh must be on <br /> C��ncrota,P,sptwh, <br /> r Plywood,��r n Tarp. <br /> Propane Ta <br /> ww.MWM. ru,ewarr �e.��wwew � Galbxga <br /> Can <br /> �rc EpirwWrrhar <br /> 5:,.�:,:•. walnr <br /> �Ice-b-00-1-' <br /> er I 5Gal HOW rrasri <br /> S.M 6 Bop:a four Car,wra.muu6e wannwnwr convene. <br /> ._.,..—.__..�_..,_. xoroCeer,Mf-aidawora+,rn' <br /> 1868 E. Haxelton Avenue I Stockton,California 95205! T 209 468-3420 1 F 209 464.0138 1 www.sigov_cargrr:itci <br /> hitps:IlmaiLgoogle.corn/mailfu/O/#search/BOSS+MOlQ(ircJHriCsBXLNTStWXBtSVnc3MCwFMIcGwb?r)roiector=l&messaaePartld=0.1 111 <br />