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S A N J a AQ U 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`F temperature): <br /> ❑Ice chests ❑ Refrigerator u,5 <br /> Refrigerated truck L� <br /> Ice bath and tubs u I C <br /> ❑Other(specify) <br /> 11 l am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br /> ❑Three compartment sink <br /> OR <br /> f�LThree deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br /> tolution (one tablespoon of bleach per gallon of water) <br /> ®Detergent, bleach, and wiping cloths(cleaning towels) <br /> Pa 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'E (i.e. 5-20 gallon container with spigot). <br /> One separate tub(bucket or basin)for the collection of nnselwatstewater. <br /> ®Paper towels and pump-style soap container <br /> 13. Names of res risible persons to tee/Rresent in booth during all hours of operation: <br /> l�e-4 S2 6,i-',E <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 aploperation. Return original for festival coordinator three weeks orior to <br /> this event. <br /> 14. Completed by: <br /> Signat ZiTI© Date <br /> szo c� <br /> }f'2.fSh Pennd `I Hand w %h water <br /> sierra�Cnart.q <br /> Dian <br /> Ag7ef HaM Ttrdnla <br /> 5nan dl{pBrratr <br /> C�•S;r'w1i� riA>Zrtl2er burlsel- <br /> hJsaGr d,wafer for <br /> Prppyy Stove k�ech <br /> yfa"119 dcdv <br /> Booth must be on <br /> Concrete.Asphalt, <br /> Pl"rYA,rff a Tarp. <br /> .Sarp enr++f.w nvucv itwm- �,n„r+tfroa• Garbage <br /> FKa Ebr,aud.r L� Can <br /> r,va <br /> weer <br /> �M Coder- "" <br /> Fahe kn BLV,6 Food rrvW—MM NNW be .1 Wswewaw Cpnfamw <br /> stand d NKIFM ne d"prar:dl <br /> 1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-3420 1 F 209 464-0138 1 www sjcehd com <br /> 4)2 <br /> 07rN,7 Pape a a 11 <br /> TEMP EVENT APP <br />