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,AN a Q A Q U I N Environmental Health Department <br /> COUN <br /> 10. 1 am prcvkJing the fallowing cold temperature control for the coid holding d potenhalty hazardous for-Os :,eo%v <br /> 45`F Id icod is used the following day.maintain below 41'F terroerature;: <br /> ❑ toe chests ❑Refrigerator <br /> fl Refrigerate-d truth ❑t+•e bath and tubs <br /> ❑Other i sc cify.t <br /> 11 1 am r rovidtng the following sterns within my booth for the sanitary cieannng of food r reparatoDn utens.i <br /> 0 Three compartment sink- <br /> OR <br /> ❑ Three deep tubs 11bases 6-8 inches mnmumi. cne for soapy water we tor nnsmg and one for a viaact', <br /> solution+;cne=Iespoon of bleach per gaaan of water,. <br /> Detergent.oleach,and vapmg cloths tcieaning io%%sls I <br /> Tub to slore mpc,g cloths in bleak,solution. <br /> 12. I am providing the followir►a for actuate hand washing faoides. but separate from utensd ;crash w4hin my <br /> booth: <br /> ❑Q Water supply dispenser wits,warm water at a minimum of 1004F{i_e.5-20:_,a'Bryn container with sD-coti <br /> One separate tub jbucket or=as i1) for the collection of rinse:wastewater. <br /> ❑ Paper toti+els and soap oantaiier. <br /> Names of resoonsso=persons to tw present in bcKAh during.a;'hours of ooeratnon. <br /> HLYT.n. <br /> —Important" All food vendor czoihs are subject io inspection. P--ase mane a copy of this avplravon r <br /> preparation for this event. A. copy of this check!--.St rr,usi be =r, tr,e bWh at all IrDurs _,I <br /> preparation and operation. Retum original to festival coordinator three weeks prior to <br /> this event- <br /> 14. Completed by: <br /> Signature Title Date <br /> siu sr <br /> Nealtr, Pc-rmit <br /> * Pww Had Task <br /> Sc>r.ewRrtan ,� <br /> Selma E a <br /> 6Yal a i av� <br /> I <br /> tBMh RrM be ors <br /> II — Concrae.As~. <br /> ='ywrl rid Ora TaT <br /> MYa <br /> r <br /> _r <br /> lee Gaoler � �6an.aa,aa• <br /> __.___..__._...__ an.eaJndaad►dl9.po.s _ <br /> 1.568 E. Hazelton Avenue I Stockton_ Caiifun a 95205 T 209 468-3420 F 2W 464-0138 1 wwk .s3gov.orq'ehd <br /> Ero 16-02 TEMP euENT APP <br /> oa7si xrz� <br />