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r <br /> Y S A N J Q QQ U I N Environmental Health Department <br /> Jli`� COUNTY— <br /> ��''` Gr�etr+ras rrnnc hr; <br /> 10_ 1 am providing the following cold temperature control for the cold holding of potentlalty hazardous foods bxelow <br /> 45"F Id food Is used the following day.maintain below 41,F temoeraturey: <br /> (JIce chests ❑Refrigerator <br /> 0 Refrigerated truck ❑ice bath anc tuns <br /> Other fsDecifyi <br /> 11 1 am orovicIng the following Items wittun my booth for the sanitary cleaning of food preparation utensil <br /> Th ree com;oartment sI nk_ <br /> OR <br /> [3Three deep tubs 1pasns t,5 Inches minimuml. one for soapy water.. one for rinsing and coe for a p!eazh <br /> solution tale tabler�pn of bleach per gallon of waterg. <br /> Fj]Detergent,bleach.and wiping cloths(cleaning to weld. <br /> ®Tut)to store wiping cloths In bleach solution. <br /> 12. 1 am oroocmg the following for a-dequate halnd washing facilities but separate from utensil wash within my <br /> booth <br /> t]Aater supply cispenser w1tti warm water at a minimum of 100'F 0.e. 5-2u-gallon container with sorg I.1- <br /> In One separate tub l riucket or basin l for the collection,ot r►nse;wastewater. <br /> LJ Paper tc,Yefs and pump-style soap container. <br /> I{ Nacnes of reponstniE-persons to be present in booth during all hours at operation <br /> Larryrarrard <br /> "Important' All food vendor booths are subject to inspection. Please make a copy of this application I <br /> preparation for this event. A copy of this checklst must be m tree booth at all rtours of <br /> preparation and operation_ Retum original to festival coordinator three weeks prior to <br /> this event_ <br /> 1d. ;:ompletee by: - .E w� --- ceo 8;`1 21/202 <br /> S ature Title Date <br /> �m <br /> Health Permit '*"a Aa r <br /> W-=ftAtnp <br /> �r <br /> Poor F1rC T:rW <br /> rx.aysr.a�r <br /> SrPr b turf.• <br /> �J tla i Mr"r <br /> I I <br /> — I _ Boofh Rant be an <br /> It 11 "PYMtbd.or_ I;[ <br /> - <br /> lll -"1 <br /> rr[sir <br /> U Yvar.r <br /> Ice Cooler <br /> [ss b aY�f{f�d+bewrs rsti b ���C°retie <br /> coed is nbor dr of A Pend <br /> 1%8 E. Hazelton Avenue I S+tockton-C:aldorna 952US 1 T 209 468-3420 F 209 464-0138 ( www.sfgov.orgl'ehd <br /> EhO 1&a2 Page a d 11 TEMP EYBdr APP <br /> 0&296 3 <br />