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S A N J Q A Q U I N Environmental Health Department � <br /> 10. I am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br /> 45°F (if food is used the following day,maintain below 41°F temperature): <br /> Tice chests ❑Refrigerator <br /> ❑Refrigerated truck ❑ Ice bath and tubs <br /> ❑ Other(specify) <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 bleach <br /> solution(one tablespoon of bleach per gallon of water). <br /> E[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 band washing faculties, but separate from utensil wash within my <br /> booth: <br /> ❑Water supply dispenser with warm water at a minimum of 100°F(Le.5-20 gallon container with spigot). <br /> 0,0ne separate tub(bucket or basin)for the collection of rinselwastewater. <br /> paper towels and pump-style soap container. <br /> 13. Names-pLresponsible 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 or' in-f to festival coordinator three weeks prior to <br /> this event. <br /> 14. Completed by; 0 W FCC <br /> Slgnatu Title Date <br /> 5-20 Gal. <br /> Health Permit hand wn•Jr wnlw <br /> �laad alCJ,alr,np <br /> p,clr f aner Hand TMML <br /> 9wP d+spcnar <br /> Cu:Un9 f)aard S3hWO 6uSAcrl. <br /> W ffi d aalm far <br /> Propane ELU.0 f31rarh ctcnng rnOM rlxf+: <br /> Booth must be on <br /> Concrete.Asphalt, <br /> ❑` Plywood,or a Tarp. <br /> Prr,Rano Tonk <br /> sMP and wale Na%o vlolm 8103 1 and Wa1w Garbage <br /> Carl <br /> rue EarrtALenar <br /> Ercrn <br /> Ice Cooler r.Gal Hand%.1101 <br /> E Vra R:u 600:d 1; J CwIfjovos muff bu wulavalol cop,la:ner <br /> V-V-J 6 fithna rdi cf 01r FOUP f <br /> 1668 E.Hazellon avenue I Stockton, Caldnrnta 95205 E T 209 468-3420 1 F 209.164-0136 1 vAv:v.slgov.orglehd <br /> LHD 1&02 PaOu 6 of 11 TEMP EVENT APP <br />