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's <br /> li <br /> SAN 1DAQUIN Environmental Health Department " <br /> i c c�4 3 t� l Y <br /> 10. 1 am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br /> 45eF(if food is used the following;Refrigerator <br /> y aintain below 41 OF temperature): <br /> ❑Ice chests <br /> i <br /> ❑refrigerated truck ❑ Ice bath and tubs <br /> ❑Other(specify) <br /> t <br /> e 11. vaproviding the following items within my booth for the sanitary cleaning of foodd preparation utensil <br /> ee 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 /> so ion (one tablespoon of bleach per gallon of water) <br /> g LMp etergent, bleach,and wiping cloths(cleaning towels). <br /> Tub to store wiping cloths in bleach solution. <br /> 12. l am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br /> booth. <br /> ater supply dispenser with warm water at a minimum of 100°F(i.e, 5-20 gallon container with spigot). <br /> [;J ne separate tub(bucket or basin) for the collection of rinse/wastewater. <br /> p / 1 <br /> aper towels and pump-style soap container. <br /> ii <br /> 13. {Names of respons le 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 application in <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 /> a this event. <br /> i <br /> 1 14. Completed by: - <br /> Signature Title Date <br /> Health Perini! Hand wash Wa[e, <br /> Slerno wr'ham 11.1 <br /> ' �� iy:per FiRnd Tornals <br /> sWp tlrspcnser <br /> GulRnp£qa+d Sanrw er bucket <br /> blench a.ater far <br /> Propane 51Ave <br /> 8baah storing wpsp closes <br /> Booth must be on <br /> Concrete,Asphalt, <br /> LF <br /> a Plywood,or a Tarp <br /> Rvpane'•v <br /> Soap and Water Rinse Water Glrach and Wale, <br /> Garbage <br /> Can <br /> F dip✓=rtingurahor <br /> k.x[ra <br /> \"i rlef <br /> rice Cooler 5 Gal Hand wash <br /> Wdstumtel conilwer <br /> st-va 6�nea nfro"ofGunir <br /> 1868 E Hazelton Avenue I Stockton, Caiifofnia 952051 T 209 468.3420 I F 209 484-0138 1 www.sjgov.org/ehd <br /> EHD 1&02 Pape 8 0l t 1 TEMP EVENT APP <br /> 0&1B119 <br />