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SA N WHO O Eltvironmental Health Department <br /> 1Ci. I an-L proviaing the follc,winq cold temperature control for the c,olti holding of patantially hazardous foods below <br /> 45°F (if food is used the ioiloWnq day, maintain below 41°F temperature)- <br /> Ice rhests RPfriyeCator <br /> Refrigerated truck ] Ice batty and tutis <br /> i Other(speC.ify) _— <br /> 1. 1 am providing the following item&within my booth for,tll Satittttry r.I�sanirtiU of fcxsri preparation utensil <br /> Three -oinpa 1ment sink, <br /> OR <br /> Three deep tubs (basins (3-t3 inches minimum), one for soapy water, one for rinsimg and one for a bleach <br /> solution (one tablespoon of bleach per gallon of water). <br /> [] Detergent, bleach,and wiping cloths Eclaaning towels). <br /> Fj Tub to store wiping cloths In bleach solution. <br /> 12. l aM pmvicting the tollowing for adequate nand washing faulities, but separate from utenslE wash within my <br /> booth: "r,r- <br /> ❑Water supply disperser with warm water at a minimum of 100'F (i.e. 5-20 gallon container witl-spFgot). <br /> [}one separate tub(bucket or basin)for the coilection of rinse/wastewater. <br /> Paper towels and Vim. -st a Soa container. <br /> 13. h.erpes of responsible persots to be present in booth during all fxvrs of operatim <br /> *Imnr ortant'" All food vendor booths are subject to inspection. Please make a copy of this application C <br /> preparation for this evenL A copy of this checklist must be in the boon at all hours of <br /> preparation and uperation, Return original to festival coordinator three weeks gCW 60 <br /> 14. completed by: this event, ��, <br /> Si ature Title Date <br /> _2c <br /> I-lFsttt�r pernllt ; Maid wash Wad•r ' <br /> 516rco w/Ch*ftnu - <br /> SeAp'.tfsoenetr ..` <br /> � � eoolElrrxireC{�an. <br /> Ice Cooley S G6'.liana+rase <br /> i �le.Y.-rr+S Nu..�(',;oruary rts!.7:8 oY,Hil4.wdC�r�gn;aytl. _ <br /> 1858 E. tazel♦on A,, Califo:nid 55205 T -rJ d- ti ~ 2�r� < h- 0138 VWY:.`.�I ) <br /> nwM"74 <br />