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f <br /> SANr=�QAQIN Environmental Health Department <br /> C:0UNTY <br /> Greatness grows here. <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 OF temperature): <br /> fce 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 /> ,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 /> water supply dispenser with warm water at a minimum of 100°F(i.e. 5-20 gallon container with spigot). <br /> .2'0ne separate tub(bucket or basin)for the collection of rinsetwastewater. <br /> F-L,Oaper towels and pumt7-s ie soar)container. <br /> 13. Names of responsible persoap to be present in booth during all urs 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. Return on inal to festival coordinator three weeks prior to <br /> this event. . <br /> 9/14. Completed by: � (it�/�c�t_ f`f <br /> "jnaturfe Title,,,,,,.,,, �, 1 <br /> Date <br /> 5-20 Gel <br /> Health Permit Ste HwWwa.hwmer <br /> mo wlChaffing <br /> Dish <br /> Paper Hard Tavefs <br /> Soap disreruer <br /> Cudvg Board Sanilizer burhet- <br /> oteach E water for <br /> Propane Stare Bleach 51-Mg wiping Cloths <br /> Booth must be on <br /> Concrete,Asphalt, <br /> Plywood,or a Tarp. <br /> Prapana Tank <br /> Soap and Water Rinse Water Beach and Water Garbage <br /> Can <br /> Fire Extmisher <br /> Water <br /> Ice Coole $�,,�,,,�„ <br /> =:,' <br /> a FaW Containers must Ge Waatewetar C or!o/the ground! <br /> 1868 E. Hazelton Avenue 1 Stockton, California 95205 T 209 468-3420 IF 209 464-0138 1 www.sjcehd.com <br /> EHD 1"2 Page 9 of 11 TEMP WENT APP <br /> 071,V17 <br />