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SAN -JOAQUIN 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"F temperature): <br /> ❑ Ice chests ❑ Refrigerator <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 food preparation utensil <br /> [R 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 /> 9 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 rinse/wastewater. <br /> ❑ Paper towels and pump-style soak container. <br /> 13. Names of responsible persons to be present in booth during all hours of operation: <br /> Q <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 on inal to festival coordinator three weeks rlor to <br /> this event. <br /> 14. Completed by, <br /> Signature Title Date <br /> 5-20 Gal <br /> Hard wash Water <br /> Health Permit Sterne wlChaF}np <br /> Dish Paper hand Torrcls <br /> Soap dispenser <br /> sanibzef b�cX01- <br /> Cu[hng Scam bleach S water for <br /> sWring wipino cloths <br /> 8leadi <br /> propane Stave <br /> Booth must be on <br /> Concrete,Asphalt, <br /> Plywood,or a Tarp. <br /> Propane TanK <br /> Snap and Water Rinse Watef Garbage <br /> Can <br /> r.re Erhnguisher <br /> Eslra <br /> Water <br /> ti Ice Cooler <br /> I Exirn Ice Sags 8 Food Containers musr be W aelewaler Gonrmnar <br /> sf� d 6 inches offor rho ground, <br /> 1363 E. Hazelton 952051 T 209 466-3420 F 209 464-0138 1 v s1gov 01'g,ehd <br /> EH0 1"2 Page&of 11 TEAF EVENT APP <br /> 0612912023 <br />