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r <br /> 2 S A N J O A Q U I N Environmental Health Department <br /> t4 " C 4U N T Y-.. <br /> Cff?Ot^£'SS t3fQ:tc t+ <br /> 10. 1 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 /> Ice 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 /> �hree deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br /> sol on (one tablespoon of bleach per gallon of water). <br /> [TD tergent, bleach, and wiping cloths (cleaning towels). <br /> Q�b to store wiping cloths 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 /> &�ater 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 collection of rinse/wastewater. <br /> 19/paper towels and pump-style soap container. <br /> 13. Names of resp iG ib�lerson$to b� present in booth during all hours of operation: , <br /> V 40r <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 /> this ey6jat. <br /> 14. Completed by: <br /> Signature Title Date <br /> = ': 5 20 Gal. <br /> Health Permit Hand wash Water <br /> Sterno w/Chaffing <br /> Dish <br /> Paper Hand Towels <br /> Soap dispenser <br /> Cutting Board Sanitizer bucket- <br /> bleach&water for <br /> Propane Stove <br /> Bleach storing wiping cloths <br /> Booth must be on <br /> Concrete,Asphalt, <br /> a vim. w. Plywood,or a Tarp. <br /> Propane Tank <br /> „-?�` Soap and Water Rinse Water Bleach and Water Garbage <br /> Can <br /> Fire Extinquisher <br /> 6m-a <br /> ,r----� Water <br /> Ice Cooler I 5 Gal Hand wash <br /> Extra Ice Bags&Food Containers must be Wastewater Container <br /> —M-----m--•---•------'� stored 6 inches offot the ground! <br /> 4 OGO c LI..-..la,... A..--.... 1 C`a.,..l.a-- r1Cnf%C 1 T 'IfNn AGO ')Ann 1 C 7r1f1 ACA fl-i'30 1 ................ ......t..L.A <br />