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I <br /> SANjiMOWN Environmental Health Dep-�irtment <br /> CoUN- ,�— <br /> '7r <br /> 1, I am prcviding the folly vying ccic temperature control for the cold holding of pctentalry hazardous [axis c».Ec"ti <br /> F I d tooc is used the following day.maintain belcyn 41-F temperature;. <br /> Ir_e chests ❑'tetng-eralor <br /> ❑ Refrigerated truck ❑#ce bath and tins <br /> ❑Other Isaecity) <br /> 11_ I am providing the foliowinq items within my booth for the sanitary cleaning of food preparaton utensil <br /> ❑Three comciartment strip <br /> OR <br /> ❑ Three deep turns lbasns 6 8 inches minirnuml_ one for soapy Neater_ one for rinsing and one for a t4each <br /> solubon lone tablespoon of beach per gallon of water+. <br /> Q Detergent.(bleach.and•mping cloths(cleaning towelsf_ <br /> Tub to store mpnq cloths in bleaca-,solution. <br /> 12_ 1 am proAdinq the following icy adequate hand washing facilities. Gut seperate from utensil wash within my <br /> booth_ <br /> ❑Water supply dispenser with warm water at a min,rr,um rJ 1fWF I e-5-20galon container with spigotl_ <br /> ❑One separate tub (bucket or bas n) for the collection :A nnser'wastewater. <br /> ❑ Paper icNNels and pumc�syoie soap container. <br /> I:a. Names of rest-ons,ble persons to be present in Gooth,during all hours of oceeration <br /> "Important" All food venclor booths are subject tic+ inspection. Please make a copy of this application n <br /> preparation for this A :0P. this d>zcMist must be in the booth at all ttDurs W <br /> preparation and operation_ Return or stival coordinator three weeks prior to <br /> this ever <br /> 1,1. ,•.;cmp�letee by: 2 <br /> �Ignature Title at <br /> o-M Go <br /> Health Permit <br /> T nr <br /> vs.n..s r— <br /> Seap•frpnr�ar <br /> SAMUM euEka- <br /> Much a river <br /> Psncar�Sn�n <br /> n.� X-nno-s-a eon,. <br /> Booith mis:Gc=r <br /> Concrve <br /> II 1 1 Plywood.or a I lip. <br /> V 4 <br /> Per T�tt <br /> �•�C r�'ry'�dt <br /> Cara <br /> W+u <br /> Ice Cooler Isrrirw�e,s, <br /> CaQa Am aMW[ro d tanmaAz rmof to W&AS6 ..CAMM. <br /> I'll"6 lr�i d d!�Pns�1 <br /> t B68 E. Hazelton Ayertue Stockton Caldorrda%205 T 209 468-3420 F 2W 464-0138 www.sfgov.orglehd <br /> ErD 1E-02 pap s ad 11 TEMP EYIEW APp <br /> 6(s2L12T! <br />