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r <br /> S Q N J O A Q U I N Environmental Health Department <br /> -- _,j J r — <br /> �.aCy.,J`. r <br /> - tarcq;nrs« r�rr.ns �irr <br /> 1C,- I am providing the folo*ng cold temperature control for the cDid holding of potentially hazardous t:xds below <br /> s5`F I if foaa is used the following eay_maintain belan 4'­F terriperabure}: <br /> ® Ice chests ❑Refrigerator <br /> Refrigerated truck ❑1ce bath and tuns <br /> ❑Other(specifyi <br /> It- I am provicing the following items within my booth for the sanitary cleaning of food preparation utensil <br /> ❑Three compartment si nk. <br /> OR <br /> ® Three deep tui s lbasns b-8 inches minima n). one for soapy water. one for rinsing arnd one for a bleach <br /> solution tone tablespoon of bleach per gallon of water. <br /> 8 Detergent.oleach.and wiping cloths fceeaning towels)- <br /> ®Turi to store wtpng cloths in blear solution. <br /> 12- 1 am proatcing the following for adequate hared washing facilities. but separate from utensil wash within my <br /> tooth. <br /> ® J4ater supply dispenser with warm water at a minimum of 1 OWF(Le.5-20 galon container with spigotl. <br /> ®One separate tub Il:.u_ket or basin) for the collection of rinse,wastewater. <br /> Paper icmels and DurnC,Styte soap container. <br /> 13. Names of responsiale persons to be present in booth during all hours of operation <br /> D-unwile 1onrufi ur Slev iame Dwiba- <br /> "Important" All food vendor troths are subject to inspec0on. Pwase make a copy of teas a:ipir_ation n <br /> preparation for this event. A. copy of this checklrst must be in the booth at all r►ours of <br /> ��preparation and operation_ Retum original to festival coordinator three weeks prior to <br /> 14. Compleled by: s '_a owner 9i2212+024 <br /> ig nAureJ TM9 Date <br /> s.m a <br /> Healtb Permit iur[MW"""` <br /> i]fTY.i <br /> PapW had Ttw4 <br /> Mrrat l�r tr <br /> Orrtw'3�a purr mergid�la <br /> f3a01h MUM N!on <br /> Concrete.Azpeutt. <br /> Plywood.or a tarp. <br /> n4.T.r <br /> ��swdi. prm.dx.. C9artaae <br /> taw <br /> war <br /> 1 <br /> Ice Cooler ttr.>e.�. <br /> � Cal b Aqr l Fmd Co'�ra rera Er 7Yirwr Gerrnr� <br /> rn+!6 rates aR d ri oa�+a' _ <br /> 1868 E. Mazelton Avenue I Stockton.Caldornia 95206 1 T 2W 468-3420 F 209 46 -Gl38 www.sigo,..org ehd <br /> EMD 16422 Poo a d 11 TEAK'E4ENT APP <br /> 062WAM <br />