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S A N J U A Q U I N Environmental Health Department <br /> Greorness gro.5 r.pi c <br /> 10. 1 am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br /> 457(if food is used the following day, maintain below 41°F temperature): <br /> ❑ Ice chests ❑ Refrigerator <br /> ❑ Refrigerated truck ❑ Ice bath and tubs <br /> ©Other(specify) FREEZER <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 /> 3 Three deep tubs (basins " 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 Goths 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 /> [�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 c6lection of rinse/wastewater. <br /> [� Paper lowels and pump-style soap container. <br /> 13. Names of responsible persons to be present in booth during all hours of operation <br /> HUY PHAN <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_ Rgtum oft final to festival coordingt9ir three weeks PrIor to <br /> this event. <br /> 14 Completed by: OWNER 05/25/2022 <br /> Signature Title Date <br /> 52Q Q1 <br /> Health Permit 11""'Awww <br /> S unn wrCrtarrrq _ /r <br /> Soap C ciMn1M — - <br /> L.urq 6aartl —_ Sar��bcwai- <br /> biasOl d wst.r for <br /> Plopar�Sww — <br /> 61aaU AWWQ wpwv doff <br /> Booth must be on <br /> Concrete,A3phall. <br /> Plywood.or a Tarp <br /> 9owargwsW ft+vawata. efnrdrandYVat�r Garbage <br /> Can <br /> Ecn <br /> /''. <br /> waw <br /> IceCoolef 5Q.]Maaww <br /> Extra b Rags L Food Conrsrlarr—4 br Waslawww CuI rw <br /> nVw a,-Jw I dI or Ir.groe nop <br /> 1868 E Hazeiton Avenue I Stockton. California 952051 T 209 468.3420! F 209 464-0138 1 www sjgov.orglehd <br /> EHO 1 B•02 Page B or 11 TEMP EVENT APP <br /> Wiwi% <br />