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.'' SANJOAQUIN Environmental Health Department <br /> r COUNTY <br /> Greatness grows here <br /> 10 l 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 /> Oce chests ❑Refrigerator <br /> b Refrigerated trunk ❑ lee bath and tubs <br /> ❑Other(specify) <br /> 11 M prom Ing the folowing items within my booth for the sanitary cleaning of food preparation utensil <br /> roe compartment sink. <br /> Q <br /> Three deep tubs (begins 8-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br /> L6on(one tablespoon of bleach per gallon of water). <br /> etergent,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 galion container with spigot). <br /> One separate tub(bucket or basin)for the coilecfion of rinsetwastewater. <br /> Paper towels and pumr:)- We soar container. <br /> 13. Names of responsible persons to be present in booth during all hours of operation: <br /> '-bmportanC' 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. RoMm ddainal to fastivat coordinator throe weeks Prior bo <br /> this gvenj <br /> 14. Completed by <br /> Signature Tttle Date <br /> sso c.i <br /> cab <br /> Papr Hans raw. <br /> sni.a erfMnf. <br /> c�9 ea«o s..MW a,an- <br /> wndh a wrw sa <br /> Pew"Sww am@& �9�q doff <br /> Booth must be on <br /> Concrete,Asphalt, <br /> P .o aT <br /> it gg T" <br /> S&V Yid NAir ntw VM.n BlWdt W WON GAtoaga <br /> 1 <br /> YMIr <br /> Ice Cooler <br /> fE1.bn7a a wSidmusf L rd cer <br /> N e xvg "wb <br /> 1666 E Hazelton Avenue I Stockton, Cahfarnla 952051 T 209 46a-3420 I F 209 41954-0138 1 www.sjgov.ofg/ehd <br /> EHO 1"Z Papa B d 11 TE MP EYE HT APP <br /> CE IW9 <br />