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2017-05-05 17:37 Jer Jehh Inc 1209 SJC HSA P 2/2 <br /> 10. 1 am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br /> 4$* (Mod is used the following day,matntaln below 41 eF temperature): <br /> R ice chests ❑Refrigerator <br /> ❑ Refrigerated truck ❑ Ice bath and tubs <br /> ❑Other(specify) <br /> 11. 1 am providing the following items within my booth for warewashing: <br /> ❑'three compartment sink. <br /> OR <br /> 3,Three deep tubs (basins " Inches minimum), one for soapy water, one for rinsing and ans for a bleach <br /> solution(one tablespoon of bleach per gallon of water). <br /> 12. 1 am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br /> gDetergent.bleach,wiping cloths(cleaning towels),and a tub to store wiping cloths In bleach solution, <br /> 13. 1 am providing the following for adequate hand washing fatalities,but separate from utensil wash within my booth: <br /> M Water supply dispenser with warm water at a minimum of 100°F (i.e. 5.20 gallon container with spigot), A <br /> separate tub (bucket or basin) for the collection of rinselwastewater, Paper towels and a numo-style soap <br /> container. <br /> 14. Names of responsible persons to be presont in booth during all hours of operation: <br /> *"Important" All food vendor booths are subject to inspection, Please make a copy of this application in <br /> preparation for this event. A copy of this checklist must be In the booth at ail hours of <br /> preparation and operation. Return original to festival goordlostor three! iftUrior to <br /> I @van <br /> 15. Completed by: ,' ; _ -201-7 <br /> 'Signature Title Date <br /> 5'n". <br /> Health=P(3rMlt MwW wash wstr <br /> 9nrta w7Cnalruq <br /> Dish <br /> Apaf hla.'W Tpwa <br /> SoapcUpaner <br /> k:��s�Ba.ro sww�r emk.a <br /> bWadi lwararftr <br /> a.bet$ wkina wklnQ tlalhr <br /> Plnpan6 Stioy+ <br /> Booth musttw on <br /> Connate.AaphUlL <br /> 6.,.. Plywood,Ora Terp, <br /> Seep end Wear R�hul+lKlor 6WchMJWear C3eft}aoQ <br /> can <br /> pin exu�nr <br /> Ice Cooler 5&W HW'4 rr sh <br /> a&V foe aaCa 6 Porn Coe9somm mwf be W"Ir.ur cmilhkw <br /> Mond 0 rncoaa un or uw pewee, <br /> E14D 4Q-02 Pape 8 of 11 TEMP EVENT APP <br /> 71W 5 <br />