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4 ice` " y� <br /> S A N J O A Q U I N Environmental Health Department <br /> 10. 1 am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br /> Z 5*F <br /> (if food is used the following da , maintain below 41'F temperature) <br /> ce chests 5Refngerator <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 rood preparation utensil <br /> ❑ Three compartment sink. <br /> OR <br /> Three deep tubs (basins 6-8 inches minimum), one for soapy water one for rinsirg and ore for a bleach <br /> solution (one tablespoon of bleach per gallon of water). <br /> ❑ Detergent, bleach, and wiping cloths (cleaning towels). <br /> ❑ Tub to store wiping cloths in bleach solution. <br /> 12. 1 am providing the following for adequate hard washing facilities, but separate frorr utensil wash within my <br /> booth: <br /> ❑ Water supply dispenser with warm water at a minimum of 100'F (i.e. 5-20 callon container w11h spigot} <br /> ❑ One separate tub (bucket or basin) for the collection of rinse/wastewater. <br /> ( ] Paper towels and pump-style soap container. <br /> 13, Names of responsible persons to be resent in booth during all hgurs of operation y <br /> **Important** All food vendor booths are subject toot this cclheckl�se musase t be be `ake r he boothCooy of at ap hours of <br /> preparation for this event. A copy <br /> rn original to festival coordinator three weeks prior to <br /> preparation and operation. Retu <br /> this e_= of <br /> , <br /> 14. Completed by: Signature Title <br /> Date <br /> y�- 3a. <br /> Nand�.ras <br /> Health Permit steno w+cna�rny Facer ward'�WQ's <br /> Dish <br /> Soap d sDersc� <br /> I Sarntzer bucKet <br /> g,water`cs <br /> Ct/t�0 Board � s:�rn�v�;>tn3 aot'ts <br /> Neach <br /> PMWW <br /> � Booth :Concrete, <br /> Asp <br /> Plvwoor a <br /> Tsnin <br /> Rin water Bjeactt and Watt+ I Garbage <br /> soap and Water se Can <br /> Ewa <br /> n ishar <br /> Fate E>m' ov wato:or <br />