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S A N tJ 0 A Q U I N Environmental Health Department <br /> 4 U1 K& C O U N 1 Y--_ <br /> G-rr otr=nss gro,s herd. <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 /> Vice 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 /> so}Gtio one tablespoon of bleach per gallon of water). <br /> WJ tergent, bleach, and wiping cloths (cleaning towels). <br /> ub 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 /> [Water supply dispenser with warm water at a minimum of 100*F (i.e. 5-20 gallon container with spigot). <br /> �ne separate tub (bucket or basin)for the collection of rinse/wastewater. <br /> aolaper towels and pump-style soap container. <br /> 13. Names of responsible person to br <br /> sent in oth during all hours of operation: <br /> On <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 event. <br /> 14. Completed by: o1)'xay— 9` � <br /> Signature Title Date <br /> 5-20 Gal. <br /> Health Per Hand wash Water <br /> Stemo wiChaffing <br /> Dish Paper Hand Towets <br /> Soap dispenser <br /> Cutting Board Sanitizer bucket- <br /> bleach&water far <br /> Propane Stove <br /> Bleach storing wiping cl s <br /> Booth must be on <br /> Concrete,Asphalt, <br /> u' ah f Mr Plywood,or a Tarp. <br /> .. <br /> Propane Tank <br /> Soap and Water Rinse Water Bleach and Water <br /> Garbage <br /> Can <br /> Fire Extinguisher <br /> Extra <br /> Water <br /> Ice e Cooler .i 5 Gal Hand wash <br /> Extra Ice Bags&Food Containers must be Wastewater Container <br /> -- —-- -•-- ---- stored 6 inches off of the ground! <br /> 4000 1- U..-...la-- A...,...... 1 OC'UNC 1 T r)r%n ACO 9A VN 1 C 'If)n ACA r\q O0 1 ................ ......L.L..J <br />