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S N WO ry F..nviroTivw�ntal Health Department <br /> 10. t am pmvidfng lhP tolowing mild Ittrrrper:alme..control for We. rxiltl hnkllnp of potentially ha7wrinus food!-, tx inw <br /> 45°F tit Wd is used the fnitowm a day.rP,'trnlnilr belnw 41 't lntnperaturel <br /> ice CtlCSts j RefriOM 1tln <br /> [�Refrigerated 1n:c:k [ 1 lot'both alnd tiny; <br /> f 1. !am pinvYEinQ the following items within my txtolll for the sanitary rleanrng of food preparatron t1f?nsit <br /> jX Three.e.corrlpariment sink <br /> OR <br /> Q Three deep tubs (basins " inches minimum), one for soapy water, one for rinsing and one for a bleach <br /> oDM*n(one tablespoon of bleach per gallon of water). <br /> Deterpenl,bleach,and wiping Goths(cleaning towels), <br /> ub to store wiping cloths in bleach solution <br /> 32 1 am pro,0dmg the fotlovnrg for adequate hand washing facilities, but separate from utensil wash -within my <br /> booth. <br /> PizWater suppty dispenser with warm water at a minimum of 100°F(i.e.5-20 gallon container wrth SOO)- <br /> Pone separate tub(bucket or basin)for the collection of rinse/wastewater. <br /> YQ Paper towels and dump-stvie soap container. <br /> Names of,asponstble persons to be present in booth during all hours of Operation <br /> — M A k'� <br /> *'important" All food vendor booths arF subject to inspection. Please slake a copy of this aPr)i"Cai:Cr: �rri <br /> preparation for this event. A copy of this checklist must t:e in the booth a' all <br /> preparation and operation Retunl on vial to festival coordinator three weeks prior to <br /> this event <br /> .4 Ccrnpleted by: <br /> Signature Title Bate <br /> ten!w„r,waee. <br /> i Hea�—I <br /> SoeO J,sP�nuer <br /> FtS.7•: <br /> _ f�YYh-T15r Dew <br /> ccvrrete.ksp ra& <br /> f � rlYWcxr,'Na T3M. <br /> r•r,.ur l.l'ti' <br /> at <br /> l:,yl1 <br /> L.na <br /> WR.ln <br /> Ice Cooler 7 <br /> — ' 2vM 4—hl a�r„10..WumQ' <br /> 1868 E.Hazenon Averwe I Storklort,Galifornia 95205 I T 20(1 408-3420 i F 209484.0138 1 www Sjgt)y org:ehd <br /> o•n rem Page e a 11 r Ehr EVEWT APP <br /> try <br />