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SAN JOAQU 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 /> 45'F (if food is used the following day. maintain below 41'JF temperature): <br /> ❑ Ice chests ❑Refrigerator <br /> ❑ Refrigerated truck ❑ Ice bath and tubs <br /> Other(specify) Not servin cold food <br /> 11 1 am providing the following items within my booth for the sanitary cleaning of food preparation utensil! <br /> ❑ Three compartment sink. <br /> OR <br /> Three deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one 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 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 /> One separate tub(bucket or basin) for the collection of nnselwastewater <br /> XPaper towels and oum -s le soapcontainer <br /> 13 dames of responsible persons to be present in booth during all hours of operation: <br /> Kishawn Bennett <br /> "Important" All food vendor booths are sublect to inspection. Please make a copy of this application In <br /> preparation for this event. A copy of this checklist must be 1n the booth at all hours of <br /> preparation and operation. Return original to festival coordinator three weeks prior to <br /> this event. <br /> 14. Completed by Kishown Bennett Owner Nov 28th, 2024 <br /> Signature Title pate <br /> r� <br /> Health Permit <br /> Saar+,,drp,r,irr■� <br /> �.rsUr+'S O+H ud 1 ,.n•n•.+r':..r Knf <br /> Booth atust bu on <br /> f Concrete Asohall. <br /> Plywood.or a Tarp <br /> r1,:MM1 f Y+4 l V <br /> �. .a team nn•J+a , <br /> Ice Cooler <br />