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SANdOA UiN <br /> Q Environmental Health Department <br /> COUNTY <br /> Greatness grows here. <br /> 10. 1 am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br /> 45T(if food is used the following day,maintain below 41°F temperature): <br /> HIce chests ❑Refrigerator <br /> ❑ Refrigerated truck ❑Ice bath and tubs <br /> (] Other(specify} <br /> 11. hl providing the following items within my booth for the sanitary cleaning of food preparation utensil <br /> M'Three compartment sink. <br /> OR <br /> ( hree deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br /> solytlon(one tablespoon of bleach per gallon of water). <br /> Detergent,bleach, and wiping cloths(cleaning towels). <br /> ErTub to store wiping cloths in bleach solution. <br /> 12. 1 am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br /> booth: <br /> Water supply dispenser with warm water at a minimum of 100°F(i.e.5-20 gallon container with spigot), <br /> ,,2" ri <br /> One separate tub(bucket or basin)for the collection of nse/wastewater. <br /> Ly'/Paper towels and pump-style soap container. <br /> 13. Na <br /> s of responsible persons to be present in booth during all hours of operation: <br /> A—ff� (,J 0 /1 S <br /> **Important** All food vendor booths are subject to inspection. Please make a copy of this application in <br /> preparation for this event. A copy of this checklist must be in the booth at all hours of <br /> preparation and operation. Return original to festival coordinator three weeks prior to <br /> this eve <br /> 14. Completed by: _ — 74, S <br /> ignature Titie Dat <br /> 5.20 Gal. <br /> Health Permit Hand wash Water <br /> Stxnn..rCh.m.q <br /> ash Paper Hand Towels <br /> Soap dlsponsM - <br /> CutGng Berard SanAlxor twckot- <br /> bleoch&wince for <br /> Propane Slave Bleach <br /> storing wiping doths <br /> Booth must be an <br /> Concrete,Asphalt, <br /> Plywood,or aTarp. <br /> Propane Tank <br /> Soapondwalor RlaseWater Bleach andw•ur Garbage <br /> ^�..� Z Can <br /> Fire Eafnguishet <br /> Ears <br /> water <br /> Ice Cool C Sfial Hand wash <br /> F-bv!ca BpIA d Food Ccnf*kwrx mwf bo Wastewaw r C;adal wr <br /> atoned 8 Nchas ol1 or the orc4nd7 <br /> 1868 E.Hazelton Avenue I Stockton,California 95205{ T 209 468-34201 F 209 464-0138 1 www.sjgov.org/ehd <br /> EHO 16-02 Page 8 of 11 TEMP EVENT APP <br /> o61t9119 <br />