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A U N Environmental Health Department <br /> _ SAN J,JO 4 <br /> —COUNTY <br /> Gfeotnrss grows Inert. <br /> 10. 1 am providing the following cold tempera re control for the ain below 41'F temperature):holding f potentially hazardous foods below <br /> 45`F (if food is used the follow) d y, <br /> [] Ice chests <br /> Refrigerator <br /> [] Refrigerated truck ❑Ice bath and tubs <br /> Q Other(specify) <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 and one for a bleach <br /> �] Three deep tubs (basins 8-8 inches minimum), one for soapy water, one for rinsing <br /> solutim (one tablespoon of bleach per gallon of water). <br /> EJ 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 100aF(i.e.5-20 gallon container with spigot). <br /> ❑One separate tub(bucket or basin)for the collection of dnsetwastewater. <br /> ❑Paper towels and pump-style soap container. <br /> 13. Nawom of responsIbliq persons to be present in booth during all hours of operation: <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. Retunn original to festival coordinator three weeks prior to <br /> this event. r f <br /> 14. Completed by: <br /> Signature %� ltle ate <br /> 6-20 Gal. <br /> Health Permit "mnd WONst«fw.dcrwory <br /> D'ah <br /> P"Hrrd 7ovnrb <br /> S.wp iif:.Muw <br /> Cult rq Doard sarrt�zer"-Id <br /> d- <br /> _ blt,yr.�8.YINIUf ra <br /> IOW storing wlpinp c!aths <br /> i <br /> k Booth must be on <br /> Concrete,Asphalt, <br /> Plywood,or a Tarp. <br /> ?r,w.Tan) �.......... - _.. _ . .. <br /> Soap and Wal+r�, ni a.x'l:t,:au <br /> WF7­ <br /> [7.---,. ! GarbageCantioCarrerwa rnw!W w�hrlbs on d ft gra.ner <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 F 209 464-0138 cand.corn <br /> DE e-02 www.sj <br /> Page 8 of 1 t <br /> TEMP EVENT APP <br />